1
|
Mustafaoglu R, Gorek Dilektaslı A, Demir R, Zirek E, Birinci T, Kaya Mutlu E, Evren C, Razak Ozdincler A. Exercise capacity, lung and respiratory muscle function in substance use disorders. Pulmonology 2024; 30:254-264. [PMID: 35115279 DOI: 10.1016/j.pulmoe.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Substance use disorder (SUD) causes conditions such as cognitive and behavioral disorders, anxiety, depression, and social isolation it also causes acute airway inflammation by affecting airway bronchial dynamics. The current study aimed to investigate the lung function, respiratory muscle strength, and exercise capacity in patients with SUD. METHODS One hundred-eighty three patients with SUD, a total of 119 healthy controls, 54 of whom were cigarette smokers and 65 of whom were non-smokers were included in the study. Spirometric tests, respiratory muscle strength (MIP and MEP), and the 6-Minute Walk Test (6-MWT) were assessed. The III National Health and Nutrition Examination Survey were used to evaluate respiratory symptoms in patients with SUD and cigarette smokers. RESULTS 86.3% of the SUD patients included in the study were using heroin, 9.2% were cannabis, and 5.5% were spice. The most common symptom in both SUD patients and cigarette smokers was shortness of breath, wheezing, and sputum production. After post-hoc tests, the FVC (p = 0.002), FVC (%predicted) (p < 0.0001), FEV1 (p = 0.002), FEV1 (%predicted) (p < 0.0001), FEV1/FVC (%) (p < 0.0001), PEF (p < 0.0001) and FEF%25-75 (p < 0.0001) lung function parameters were significantly lower in SUD patients than non-smokers. In addition, it was found that MIP (p < 0.0001), MIP (%predicted) (p < 0.0001), MEP (p < 0.0001), and MEP (%predicted) (p < 0.0001) values of SUD patients were significantly lower than non-smokers. CONCLUSION The study findings indicate that substance use has an effect on lung functions and the most commonly reported symptoms are shortness of breath, wheezing, and sputum production. In addition, respiratory muscle strength and exercise capacity were decreased in SUD patients compared to non-smokers.
Collapse
Affiliation(s)
- R Mustafaoglu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - A Gorek Dilektaslı
- Department of Pulmonary Medicine, Uludağ University School of Medicine, Bursa, Turkey
| | - R Demir
- Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - E Zirek
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bingol University, Bingol, Turkey
| | - T Birinci
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - E Kaya Mutlu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - C Evren
- Research, Treatment, and Training Center for Alcohol and Substance Dependence, Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - A Razak Ozdincler
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| |
Collapse
|
2
|
Wang RJ, Bhakta NR. The Puzzle of Marijuana Use and Forced Vital Capacity. Ann Am Thorac Soc 2024; 21:683-691. [PMID: 38271695 PMCID: PMC11109910 DOI: 10.1513/annalsats.202312-1010cme] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/23/2024] [Indexed: 01/27/2024] Open
Abstract
In study after study, marijuana use has been found to be associated with increased forced vital capacity (FVC). This is puzzling, because marijuana is commonly consumed by inhalation of its smoke, and smoke exposure of any kind is not generally considered a cause of increased FVC. Although this observation was first made decades ago, a satisfactory explanation remains elusive. In this review we survey the evidence supporting the relationship between marijuana use and increased FVC, discuss potential threats to validity when inferring causation, and, presupposing a possible causal relationship, pose two key questions. First, what are possible physiologic or pathophysiologic mechanisms by which marijuana use might increase FVC? Second, why might this effect be consistently observed with marijuana use but not with tobacco use? Explanations for the first question include lung and chest growth and remodeling from strenuous marijuana smoke inhalation and reductions in lung elastic recoil from marijuana smoke exposure. Explanations for the second include differences between marijuana and tobacco in smoke composition and patterns of consumption, such as smoking topography. Finally, the possibility that smoke, whether from marijuana or tobacco, might have nonmonotonic effects on FVC depending on the degree of exposure is explored. In synthesizing a curated breadth of epidemiologic and physiologic science, we leverage a perplexing observation to generate potential insights and avenues for further research into the biological effects of smoke, from marijuana or otherwise, on the respiratory system.
Collapse
Affiliation(s)
- Richard J Wang
- Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Nirav R Bhakta
- Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
| |
Collapse
|
3
|
Muheriwa-Matemba SR, Baral A, Abdshah A, Diggs BNA, Gerber Collazos KS, Morris KB, Messiah SE, Vidot DC. Cardiovascular and Respiratory Effects of Cannabis Use by Route of Administration: A Systematic Review. Subst Use Misuse 2024; 59:1331-1351. [PMID: 38644600 DOI: 10.1080/10826084.2024.2341317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Aim: Knowledge of the cardiovascular and respiratory effects of cannabis use by route of administration is unclear. This evidence is necessary to increase clinical and public health awareness given the recent trend in cannabis legalization, normalization, and surge in the availability and usage of various forms of cannabis products. Methods: Search was conducted in Web of Science, ProQuest, Psych INFO, Scopus, Embase, and Medline databases, and subsequently in the references of retrieved articles. Peer-reviewed articles published between 2009 and 2023, that reported on cardiovascular and respiratory effects of cannabis use by route of administration were included. Studies with no report of the route of administration and combined use of other illicit substances were excluded. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results: Of the 1873 articles retrieved, 42 met inclusion criteria encompassing six case reports, 21 reviews, and 15 empirical studies. Four administration routes were identified: smoking, vaping, oral ingestion, and dabbing. Smoking was the most common route of administration and was associated with both respiratory effects, such as bronchitis, dyspnea, and chronic obstructive lung disease, and cardiovascular effects including tachycardia, ventricular arrhythmias, and myocardial infarction. Cannabis edibles were associated with minimal respiratory effects. Tachycardia was the most common cardiovascular effect and was associated with all routes of administration. Conclusion: Cannabis use does cause cardiovascular and respiratory effects, but the conclusion remains tentative of the cardiovascular and respiratory effects by route of administration due to methodological limitations of the studies.
Collapse
Affiliation(s)
| | - Amrit Baral
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Alireza Abdshah
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- Miller School of Medicine, Desai Sethi Urology Institute, University of Miami, Miami, Florida, USA
| | - Bria-Necole Amazing Diggs
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | | | - Kyana Breche Morris
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sarah Elizabeth Messiah
- Health Science Center at Houston School of Public Health, University of Texas, Dallas, Texas, USA
- Center for Pediatric Population Health, Health Science Center at Houston, School of Public Health, University of Texas, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, University of Texas, Houston, Texas, USA
| | - Denise Christina Vidot
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
4
|
Troyer J, Tanco K. Review of the Use of Medicinal Cannabis Products in Palliative Care. Cancers (Basel) 2024; 16:1412. [PMID: 38611090 PMCID: PMC11011126 DOI: 10.3390/cancers16071412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
In this review, we discuss the potential role of cannabis and cannabinoids in the management of cancer-related symptoms. There is limited evidence demonstrating the effectiveness of cannabis-based products in treating cancer-related pain and gastrointestinal symptoms such as nausea, vomiting, and loss of appetite. Regarding the role of cannabis-based products in the treatment of insomnia and mood disorders, most studies looked at these symptoms as secondary outcomes with mixed results. Cannabis-based products have adverse effects, ranging from neuropsychiatric to systemic effects to potential drug interactions.
Collapse
Affiliation(s)
| | - Kimberson Tanco
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| |
Collapse
|
5
|
Livne O, Budney A, Borodovsky J, Shmulewitz D, Walsh C, Struble CA, Habib M, Aharonovich E, Hasin DS. Age differences in patterns of cannabis use among an online US sample of adults who consume cannabis frequently. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:242-251. [PMID: 38640463 DOI: 10.1080/00952990.2024.2309340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/19/2024] [Indexed: 04/21/2024]
Abstract
Background: Cannabis use is increasing among middle-aged and older US adults, populations that are particularly vulnerable to the adverse effects of cannabis. Risks for adverse effects differ by cannabis use patterns, which have become increasingly heterogeneous. Nevertheless, little is known about age differences in such patterns.Objective: To investigate age differences in cannabis use patterns, comparing younger (age 18-49), middle-aged (age 50-64), and older adults (age ≥65).Methods: A total of 4,151 US adults with past 7-day cannabis consumption completed an online survey (35.1% male; 60.1% female; 4.8% identified as "other"). Regression models examined age differences in cannabis use patterns.Results: Compared to younger adults, middle-aged and older adults were more likely to consume cannabis during evening hours (50-64: adjusted odds ratio [aOR] = 2.98, 95% CI 2.24-3.96; ≥65: aOR = 4.23, 95 CI 2.82-6.35); by only one method (50-64: aOR = 1.67, 95% CI 1.34-2.09; ≥65: aOR = 3.38, 95 CI 2.24-5.09); primarily by smoking as the only method (50-64: aOR = 1.52, 95% CI 1.29-1.78; ≥65: aOR = 2.12, 95 CI 1.64-2.74); but less likely to consume concentrated cannabis products (concentrates) with extremely high %THC (50-64: aOR = 0.71, 95% CI 0.54-0.93; ≥65: aOR = 0.30, 95 CI 0.16-0.55). Age differences in cannabis use patterns were also observed between middle-aged and older adults.Conclusion: Findings suggest that middle-aged and older adults may engage in less risky cannabis use patterns compared to younger groups (e.g. lower likelihood of consuming highly potent concentrates). However, findings also underscore the importance of recognizing risks unique to these older demographics, such as smoking-related health events. Consequently, prevention strategies targeting such use patterns are needed.
Collapse
Affiliation(s)
- Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Alan Budney
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Jacob Borodovsky
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY, USA
| | - Cara A Struble
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Mohammad Habib
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| |
Collapse
|
6
|
Kallurkar A, Kaye AD, Shekoohi S. Marijuana Use, Vaping, and Preoperative Anesthetic and Surgical Considerations in Clinical Practice. Anesthesiol Clin 2024; 42:53-63. [PMID: 38278592 DOI: 10.1016/j.anclin.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
In recent years, marijuana and vaping have acquired widespread popularity, with millions of people using them for a variety of reasons, including recreational purposes. However, these practices have often overlooked the implications on surgery and the preoperative anesthesia considerations. Marijuana can influence a patient's response to anesthesia, alter postoperative pain management, and increase the risk of complications, whereas vaping can have negative effects on the respiratory system and hinder the body's ability to recover after surgery.
Collapse
Affiliation(s)
- Anusha Kallurkar
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA; Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA
| |
Collapse
|
7
|
Garrett ME, Dennis MF, Bourassa KJ, Hauser MA, Kimbrel NA, Beckham JC, Ashley-Koch AE. Genome-wide DNA methylation analysis of cannabis use disorder in a veteran cohort enriched for posttraumatic stress disorder. Psychiatry Res 2024; 333:115757. [PMID: 38309009 PMCID: PMC10922626 DOI: 10.1016/j.psychres.2024.115757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Cannabis use has been increasing over the past decade, not only in the general US population, but particularly among military veterans. With this rise in use has come a concomitant increase in cannabis use disorder (CUD) among veterans. Here, we performed an epigenome-wide association study for lifetime CUD in an Iraq/Afghanistan era veteran cohort enriched for posttraumatic stress disorder (PTSD) comprising 2,310 total subjects (1,109 non-Hispanic black and 1,201 non-Hispanic white). We also investigated CUD interactions with current PTSD status and examined potential indirect effects of DNA methylation (DNAm) on the relationship between CUD and psychiatric diagnoses. Four CpGs were associated with lifetime CUD, even after controlling for the effects of current smoking (AHRR cg05575921, LINC00299 cg23079012, VWA7 cg22112841, and FAM70A cg08760398). Importantly, cg05575921, a CpG strongly linked to smoking, remained associated with lifetime CUD even when restricting the analysis to veterans who reported never smoking cigarettes. Moreover, CUD interacted with current PTSD to affect cg05575921 and cg23079012 such that those with both CUD and PTSD displayed significantly lower DNAm compared to the other groups. Finally, we provide preliminary evidence that AHRR cg05575921 helps explain the association between CUD and any psychiatric diagnoses, specifically mood disorders.
Collapse
Affiliation(s)
- Melanie E Garrett
- Duke Molecular Physiology Institute, Duke University Medical Center, 300N Duke St, Durham, NC 27701, USA
| | - Michelle F Dennis
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kyle J Bourassa
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Michael A Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, 300N Duke St, Durham, NC 27701, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Allison E Ashley-Koch
- Duke Molecular Physiology Institute, Duke University Medical Center, 300N Duke St, Durham, NC 27701, USA.
| |
Collapse
|
8
|
Chandy M, Nishiga M, Wei TT, Hamburg NM, Nadeau K, Wu JC. Adverse Impact of Cannabis on Human Health. Annu Rev Med 2024; 75:353-367. [PMID: 37582489 PMCID: PMC10947506 DOI: 10.1146/annurev-med-052422-020627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Cannabis, the most commonly used recreational drug, is illicit in many areas of the world. With increasing decriminalization and legalization, cannabis use is increasing in the United States and other countries. The adverse effects of cannabis are unclear because its status as a Schedule 1 drug in the United States restricts research. Despite a paucity of data, cannabis is commonly perceived as a benign or even beneficial drug. However, recent studies show that cannabis has adverse cardiovascular and pulmonary effects and is linked with malignancy. Moreover, case reports have shown an association between cannabis use and neuropsychiatric disorders. With growing availability, cannabis misuse by minors has led to increasing incidences of overdose and toxicity. Though difficult to detect, cannabis intoxication may be linked to impaired driving and motor vehicle accidents. Overall, cannabis use is on the rise, and adverse effects are becoming apparent in clinical data sets.
Collapse
Affiliation(s)
- Mark Chandy
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA;
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
- Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Western University, London, Ontario, Canada;
| | - Masataka Nishiga
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA;
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
- Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Tzu-Tang Wei
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA;
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
- Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department and Graduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Naomi M Hamburg
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine and Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kari Nadeau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA;
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
- Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
9
|
Khoj L, Zagà V, Amram DL, Hosein K, Pistone G, Bisconti M, Serafini A, Cammarata LM, Cattaruzza MS, Mura M. Effects of cannabis smoking on the respiratory system: A state-of-the-art review. Respir Med 2024; 221:107494. [PMID: 38056532 DOI: 10.1016/j.rmed.2023.107494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
The diminished perception of the health risks associated with the consumption of cannabis (marijuana) lead to a progressive increase in its inhalational use in many countries. Cannabis can be smoked through the use of joints, spliffs and blunts, and it can be vaporised with the use of hookah or e-cigarettes. Delta-9 tetrahydrocannabinol (THC) is the main psychoactive component of cannabis smoke but contains numerous other substances. While the recreational use of cannabis smoking has been legalised in several countries, its health consequences have been underestimated and undervalued. The purpose of this review is to critically review the impact of cannabis smoke on the respiratory system. Cannabis smoke irritates the bronchial tree and is strongly associated with symptoms of chronic bronchitis, with histological signs of airway inflammation and remodelling. Altered fungicidal and antibacterial activity of alveolar macrophages, with greater susceptibility to respiratory infections, is also reported. The association with invasive pulmonary aspergillosis in immunocompromised subjects is particularly concerning. Although cannabis has been shown to produce a rapid bronchodilator effect, its chronic use is associated with poor control of asthma by numerous studies. Cannabis smoking also represents a risk factor for the development of bullous lung disease, spontaneous pneumothorax and hypersensitivity pneumonitis. On the other hand, no association with the development of chronic obstructive pulmonary disease was found. Finally, a growing number of studies report an independent association of cannabis smoking with the development of lung cancer. In conclusion, unequivocal evidence established that cannabis smoking is harmful to the respiratory system. Cannabis smoking has a wide range of negative effects on respiratory symptoms in both healthy subjects and patients with chronic lung disease. Given that the most common and cheapest way of assumption of cannabis is by smoking, healthcare providers should be prepared to provide counselling on cannabis smoking cessation and inform the public and decision-makers.
Collapse
Affiliation(s)
- Lugain Khoj
- Division of Respirology, Western University, London, ON, Canada; Department of Internal Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | | | - Daniel L Amram
- Ambulatorio per la Cessazione del Fumo di Tabacco, ASL Toscana Nord Ovest, Pontedera, Italy
| | - Karishma Hosein
- Division of Respirology, Western University, London, ON, Canada
| | - Giovanni Pistone
- Centro per il Trattamento del Tabagismo, Local Health Unit, Novara, Italy
| | - Mario Bisconti
- U.O.C. Pneumologia - Ospedale "Vito Fazzi", Lecce, Italy
| | | | | | - Maria Sofia Cattaruzza
- Italian Society of Tobaccology, Bologna, Italy; Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
| | - Marco Mura
- Division of Respirology, Western University, London, ON, Canada
| |
Collapse
|
10
|
Lee BH, Sideris A, Ladha KS, Johnson RL, Wu CL. Cannabis and Cannabinoids in the Perioperative Period. Anesth Analg 2024; 138:16-30. [PMID: 35551150 DOI: 10.1213/ane.0000000000006070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cannabis use is increasingly common, and with a growing number of jurisdictions implementing legalization frameworks, it is likely that providers will encounter more patients who use cannabis. Therefore, it is important for providers to understand the implications of cannabis use and practical considerations for the perioperative period. Cannabis affects multiple organ systems and may influence intraoperative anesthesia, as well as postoperative pain management. The effects of cannabis and key anesthetic considerations are reviewed here.
Collapse
Affiliation(s)
- Bradley H Lee
- From the Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Alexandra Sideris
- From the Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Karim S Ladha
- Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca L Johnson
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Christopher L Wu
- From the Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| |
Collapse
|
11
|
Tuvel AL, Winiger EA, Ross JM. A Review of the Effects of Adolescent Cannabis Use on Physical Health. Psychiatr Clin North Am 2023; 46:719-739. [PMID: 37879834 DOI: 10.1016/j.psc.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
Collapse
Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
| |
Collapse
|
12
|
Mensah DN, Livingston J, Maddukuri V. Cannabis-Associated Pneumothorax: A Case Report. Cureus 2023; 15:e50825. [PMID: 38249204 PMCID: PMC10797579 DOI: 10.7759/cureus.50825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
The use of cannabis for therapeutic and recreational purposes has been on the rise in recent years. This has increased the prevalence of cannabis use disorder across various demographic subgroups. A recent medical literature review describes a few cases demonstrating the association of spontaneous pneumothorax and bullous lung disease in cannabis users without concomitant tobacco use. We herein present a case report of a young male with chronic cannabis use who presented with right-sided spontaneous pneumothorax and bilateral apical blebs.
Collapse
Affiliation(s)
- Dennis N Mensah
- Internal Medicine, New York Medical College at St. Mary's General Hospital and St. Clare's Health, Denville, USA
| | - Jonathan Livingston
- Internal Medicine, New York Medical College at St. Mary's General Hospital and St. Clare's Health, Denville, USA
| | - Vasudha Maddukuri
- Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
- Internal Medicine, New York Medical College at St. Mary's General Hospital and St. Clare's Health, Denville, USA
| |
Collapse
|
13
|
Gordon AM, Golub IJ, Diamond KB, Kang KK, Choueka J. Cannabis Abuse Is Associated With Greater Medical Complications, Emergency Department Visits, and Readmissions Following Open Reduction and Internal Fixation for Distal Radius Fractures. Hand (N Y) 2023:15589447231210948. [PMID: 38006235 DOI: 10.1177/15589447231210948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
BACKGROUND Despite increased legalization, little is known about the influence of cannabis use disorder (CUD) following open reduction and internal fixation (ORIF) for distal radius fractures (DRFs). The aims were to determine whether CUD patients undergoing ORIF for DRF have increased: (1) medical complications; and (2) health care utilization (emergency department [ED] visits and readmission rates). METHODS Patients were identified from an insurance database from 2010 to 2020 using Current Procedural Terminology codes: 25607, 25608, and 25609. Patients with a history of CUD were 1:5 ratio matched to controls by age, sex, tobacco use, alcohol abuse, opioid dependence, and comorbidities. This yielded 13,405 patients with (n = 2,297) and without (n = 11,108) CUD. Outcomes were to compare 90-day medical complications, ED visits, and readmissions. Multivariable logistic regression models computed the odds ratios of CUD on dependent variables. P values less than .005 were significant. RESULTS The incidence of CUD among patients aged 20 to 69 years undergoing ORIF increased from 4.0% to 8.0% from 2010 to 2020 (P < .001). Cannabis use disorder patients incurred significantly higher rates and odds of developing 90-day medical complications (15.24% vs 5.76%), including pneumoniae (3.66% vs 1.67%), cerebrovascular accidents (1.04% vs 0.32%), pulmonary emboli (0.57% vs 0.16%), respiratory failures (1.00% vs 0.48%), and surgical site infections (1.70% vs 1.04%; all P < .004). Emergency department visits (2.53% vs 1.14%) and readmission rates (5.79% vs 4.29%) within 90 days were higher among cannabis abusers. CONCLUSIONS With a greater number of states legalizing cannabis, hand surgeons should be cognizant of the association with increased 90-day complications and health care utilization parameters.
Collapse
Affiliation(s)
- Adam M Gordon
- Maimonides Medical Center, Brooklyn, NY, USA
- Questrom School of Business, Boston University, MA, USA
| | | | | | | | | |
Collapse
|
14
|
Rizzo G, Storz MA, Calapai G. The Role of Hemp ( Cannabis sativa L.) as a Functional Food in Vegetarian Nutrition. Foods 2023; 12:3505. [PMID: 37761214 PMCID: PMC10528039 DOI: 10.3390/foods12183505] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Recently, there has been a renewed interest in Cannabis sativa and its uses. The recreational use of inflorescences as a source of THC has led to the legal restriction of C. sativa cultivation to limit the detrimental effects of psychotropic substance abuse on health. However, this has also limited the cultivation of textile/industrial varieties with a low content of THC used for textile and nutritional purposes. While previously the bans had significantly penalized the cultivation of C. sativa, today many countries discriminate between recreational use (marijuana) and industrial and food use (hemp). The stalks of industrial hemp (low in psychotropic substances) have been used extensively for textile purposes while the seeds are nutritionally versatile. From hemp seeds, it is possible to obtain flours applicable in the bakery sector, oils rich in essential fatty acids, proteins with a high biological value and derivatives for fortification, supplementation and nutraceutical purposes. Hemp seed properties seem relevant for vegetarian diets, due to their high nutritional value and underestimated employment in the food sector. Hemp seed and their derivatives are a valuable source of protein, essential fatty acids and minerals that could provide additional benefit to vegetarian nutrition. This document aims to explore the information available in the literature about hemp seeds from a nutritional point of view, highlighting possible beneficial effects for humans with particular attention to vegetarian nutrition as a supplemental option for a well-planned diet.
Collapse
Affiliation(s)
- Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
| | - Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany;
| | - Gioacchino Calapai
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| |
Collapse
|
15
|
Coelho MP, Duarte P, Calado M, Almeida AJ, Reis CP, Gaspar MM. The current role of cannabis and cannabinoids in health: A comprehensive review of their therapeutic potential. Life Sci 2023; 329:121838. [PMID: 37290668 DOI: 10.1016/j.lfs.2023.121838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
There has been an increased interest of the scientific community in cannabis and its constituents for therapeutic purposes. Although it is believed that cannabinoids can be effective for a few different conditions and syndromes, there are little objective data that clearly support the use of cannabis, cannabis extracts or even cannabidiol (CBD) oil. This review aims to explore the therapeutic potential of phytocannabinoids and synthetic cannabinoids for the treatment of several diseases. A broad search covering the past five years, was performed in PubMed and ClinicalTrial.gov databases, to identify papers focusing on the use of medical phytocannabinoids in terms of tolerability, efficacy and safety. Accordingly, there are preclinical data supporting the use of phytocannabinoids and synthetic cannabinoids for the management of neurological pathologies, acute and chronical pain, cancer, psychiatric disorders and chemotherapy-induced emetic symptoms. However, regarding the clinical trials, most of the collected data do not fully support the use of cannabinoids in the treatment of such conditions. Consequently, more studies are still needed to clarify ascertain if the use of these compounds is useful in the management of different pathologies.
Collapse
Affiliation(s)
- Mariana Pinto Coelho
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal
| | - Patrícia Duarte
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal
| | - Marta Calado
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal
| | - António J Almeida
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal; Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal
| | - Catarina Pinto Reis
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal; Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal; IBEB, Institute of Biophysics and Biomedical Engineering, Faculty of Sciences, Universidade de Lisboa, Campo Grande, 1649-016 Lisboa, Portugal.
| | - M Manuela Gaspar
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal; Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal.
| |
Collapse
|
16
|
Barjaktarevic I, Cooper CB, Shing T, Buhr RG, Hoffman EA, Woodruff PG, Drummond MB, Kanner RE, Han MK, Hansel NN, Bowler RP, Kinney GL, Jacobson S, Morris MA, Martinez FJ, Ohar J, Couper D, Tashkin DP. Impact of Marijuana Smoking on COPD Progression in a Cohort of Middle-Aged and Older Persons. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:234-247. [PMID: 37199732 PMCID: PMC10484485 DOI: 10.15326/jcopdf.2022.0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 05/19/2023]
Abstract
Background Limited data are available regarding marijuana smoking's impact on the development or progression of chronic obstructive pulmonary disease (COPD) in middle-aged or older adults with a variable history of tobacco cigarette smoking. Methods We divided ever-tobacco smoking participants in the SubPopulations and InteRmediate Outcomes In COPD Study (SPIROMICS) into 3 groups based on self-reported marijuana use: current, former, or never marijuana smokers (CMSs, FMSs or NMSs, respectively). Longitudinal data were analyzed in participants with ≥2 visits over a period of ≥52 weeks. Measurements We compared CMSs, FMSs, and NMSs, and those with varying amounts of lifetime marijuana use. Mixed effects linear regression models were used to analyze changes in spirometry, symptoms, health status, and radiographic metrics; zero-inflated negative binomial models were used for exacerbation rates. All models were adjusted for age, sex, race, baseline tobacco smoking amount, and forced expiratory volume in 1 second (FEV1) %predicted. Results Most participants were followed for ≥4 years. Annual rates of change in FEV1, incident COPD, respiratory symptoms, health status, radiographic extent of emphysema or air trapping, and total or severe exacerbations were not different between CMSs or FMSs versus NMSs or between those with any lifetime amount of marijuana use versus NMSs. Conclusions Among SPIROMICS participants with or without COPD, neither former nor current marijuana smoking of any lifetime amount was associated with evidence of COPD progression or its development. Because of our study's limitations, these findings underscore the need for further studies to better understand longer-term effects of marijuana smoking in COPD.
Collapse
Affiliation(s)
- Igor Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, United States
| | - Christopher B. Cooper
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, United States
| | - Tracie Shing
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gilling’s School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Russell G. Buhr
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, United States
- Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research and Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, United States
| | - Eric A. Hoffman
- Departments of Radiology, Medicine and Bioengineering, University of Iowa, Iowa City, Iowa, United States
| | - Prescott G. Woodruff
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, California, United States
| | - M. Bradley Drummond
- Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Richard E. Kanner
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, United States
| | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Russell P. Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, United States
| | - Gregory L. Kinney
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Sean Jacobson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Madeline A. Morris
- College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, United States
| | - Fernando J. Martinez
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, New York, United States
| | - Jill Ohar
- Division of Pulmonary, Critical Care, Allergy and Immunology, School of Medicine, Wake Forest University, Wake Forest, North Carolina, United States
| | - David Couper
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gilling’s School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Donald P. Tashkin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, United States
| |
Collapse
|
17
|
Creanga-Murariu I, Filipiuc LE, Cuciureanu M, Tamba BI, Alexa-Stratulat T. Should oncologists trust cannabinoids? Front Pharmacol 2023; 14:1211506. [PMID: 37521486 PMCID: PMC10373070 DOI: 10.3389/fphar.2023.1211506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Cannabis enjoyed a "golden age" as a medicinal product in the late 19th, early 20th century, but the increased risk of overdose and abuse led to its criminalization. However, the 21st century have witnessed a resurgence of interest and a large body of literature regarding the benefits of cannabinoids have emerged. As legalization and decriminalization have spread around the world, cancer patients are increasingly interested in the potential utility of cannabinoids. Although eager to discuss cannabis use with their oncologist, patients often find them to be reluctant, mainly because clinicians are still not convinced by the existing evidence-based data to guide their treatment plans. Physicians should prescribe cannabis only if a careful explanation can be provided and follow up response evaluation ensured, making it mandatory for them to be up to date with the positive and also negative aspects of the cannabis in the case of cancer patients. Consequently, this article aims to bring some clarifications to clinicians regarding the sometimes-confusing various nomenclature under which this plant is mentioned, current legislation and the existing evidence (both preclinical and clinical) for the utility of cannabinoids in cancer patients, for either palliation of the associated symptoms or even the potential antitumor effects that cannabinoids may have.
Collapse
Affiliation(s)
- Ioana Creanga-Murariu
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
- Oncology Department, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | - Leontina Elena Filipiuc
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | - Magda Cuciureanu
- Pharmacology Department, Clinical Pharmacology and Algesiology, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | - Bogdan-Ionel Tamba
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
- Pharmacology Department, Clinical Pharmacology and Algesiology, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
| | | |
Collapse
|
18
|
Vásconez-González J, Delgado-Moreira K, López-Molina B, Izquierdo-Condoy JS, Gámez-Rivera E, Ortiz-Prado E. Effects of Smoking Marijuana on the Respiratory System: A Systematic Review. Subst Abus 2023; 44:249-260. [PMID: 37728136 DOI: 10.1177/08897077231186228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND The prevalence of marijuana use and its derivatives has surged over the past century, largely due to increasing legalization globally. Despite arguments advocating its benefits, marijuana smoking exposes the lungs to harmful combustion byproducts, leading to various respiratory issues such as asthma, pneumonia, emphysema, and chronic obstructive pulmonary disease. METHODS We embarked on an extensive literature search, utilizing PubMed/Medline, Scopus, Web of Science, and Google Scholar databases, identifying 200 studies. After the elimination of duplicates, and meticulous review of abstracts and full texts, 55 studies were included in our analysis. RESULTS Current literature demonstrates that marijuana use negatively impacts lung function, triggering symptoms like chronic cough, sputum production, and wheezing, and diminishing FEV1/FVC ratio in spirometry tests. Moreover, prolonged or chronic marijuana use augments the risk of respiratory function impairment. While the carcinogenic effects of marijuana are still contested, a weak correlation between marijuana use and lung cancer has been observed in some studies. Additionally, instances of other pathologies linked to marijuana use have been reported, including the development of COPD, pulmonary bullae, spontaneous pneumothorax, pleuritic pain, chronic pulmonary aspergillosis, hemoptysis, and pulmonary Langerhans cell histiocytosis. CONCLUSIONS The evidence underscores that marijuana use is detrimental to respiratory health. In light of the escalating trend of marijuana use, particularly among the youth, it is imperative to advocate public health messages discouraging its consumption.
Collapse
Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
- Pontificia Universidad Católica del Ecuador, Tecnologias PUCE-TEC, Quito, Ecuador
| | - Karen Delgado-Moreira
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Belén López-Molina
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Juan S Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Esteban Gámez-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| |
Collapse
|
19
|
Collins AB, Beaudoin FL, Metrik J, Wightman RS. "I still partly think this is bullshit": A qualitative analysis of cannabinoid hyperemesis syndrome perceptions among people with chronic cannabis use and cyclic vomiting. Drug Alcohol Depend 2023; 246:109853. [PMID: 36996524 PMCID: PMC10121940 DOI: 10.1016/j.drugalcdep.2023.109853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Cannabis is the most widely used psychoactive substance in the United States (US), with reported use patterns increasing among adults in recent years. Cannabinoid hyperemesis syndrome (CHS) has been one concern related to increased cannabis use patterns. US emergency departments have reported an increase of CHS cases over the last decade, yet little is known about CHS. This study explores the experiences of people with chronic cannabis use and cyclic vomiting and their perceptions of CHS. METHODS Semi-structured interviews were conducted with 24 people recruited from a prospective cohort of patients presenting to Rhode Island emergency departments with symptomatic cyclic vomiting and chronic cannabis use. Data were analyzed thematically using NVivo. FINDINGS Participants characterized their cyclic vomiting as related to food and alcohol consumption patterns, stress, and existing gastrointestinal issues. Despite recurrent episodes of cyclic vomiting, nausea, and abdominal pain, many participants remained uncertain whether their symptoms were driven by cannabis. Many participants relied on at-home research to assess their symptoms and seek out management approaches. Clinical treatment recommendations focused on cannabis cessation. However, most participants felt clinical recommendations failed to consider the complexity and challenge of stopping cannabis use given the chronicity of use and therapeutic benefits some perceived cannabis to have. CONCLUSIONS Although cannabis cessation is the only reported CHS cure to date, additional clinical and non-clinical treatment approaches are needed to better support people with chronic cannabis use and cyclic vomiting to meet their ongoing needs.
Collapse
Affiliation(s)
- Alexandra B Collins
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA; Providence VA Medical Center, Providence, RI, 02908, USA
| | - Rachel S Wightman
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA
| |
Collapse
|
20
|
West JL, Flores R, Sultan PK. Vanishing Lung Syndrome Requiring Bilateral Surgical Intervention in a Patient With Heavy Marijuana Use. Am Surg 2023; 89:1211-1212. [PMID: 33460333 DOI: 10.1177/0003134820984873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- James L West
- Department of Surgery, Brookwood Baptist General Surgery Residency, Birmingham, AL, USA
| | - Robert Flores
- Department of Surgery, Brookwood Baptist General Surgery Residency, Birmingham, AL, USA
| | - Parvez K Sultan
- Department of Surgery, St. Vincent's Health System, Birmingham, AL, USA
| |
Collapse
|
21
|
Tang TYC, Kim JS, Das A. Role of omega-3 and omega-6 endocannabinoids in cardiopulmonary pharmacology. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2023; 97:375-422. [PMID: 37236765 DOI: 10.1016/bs.apha.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Endocannabinoids are derived from dietary omega-3 and omega-6 fatty acids and play an important role in regulation of inflammation, development, neurodegenerative diseases, cancer, and cardiovascular diseases. They elicit this effect via interactions with cannabinoid receptors 1 and 2 which are also targeted by plant derived cannabinoid from cannabis. The evidence of the involvement of the endocannabinoid system in cardiopulmonary function comes from studies that show that cannabis consumption leads to cardiovascular effect such as arrythmia and is beneficial in lung cancer patients. Moreover, omega-3 and omega-6 endocannabinoids play several important roles in cardiopulmonary system such as causing airway relaxation, suppressing atherosclerosis and hypertension. These effects are mediated via the cannabinoids receptors that are abundant in the cardiopulmonary system. Overall, this chapter reviews the known role of phytocannabinoids and endocannabinoids in the cardiopulmonary context.
Collapse
Affiliation(s)
- Tiffany Y-C Tang
- School of Chemistry and Biochemistry, College of Sciences. Georgia Institute of Technology, Parker H. Petit Institute for Bioengineering and Biosciences, Atlanta, GA, United States
| | - Justin S Kim
- School of Chemistry and Biochemistry, College of Sciences. Georgia Institute of Technology, Parker H. Petit Institute for Bioengineering and Biosciences, Atlanta, GA, United States
| | - Aditi Das
- School of Chemistry and Biochemistry, College of Sciences. Georgia Institute of Technology, Parker H. Petit Institute for Bioengineering and Biosciences, Atlanta, GA, United States.
| |
Collapse
|
22
|
Najman JM, Bell S, Williams GM, Clavarino AM, Scott JG, McGee TR, Mamun AA. Do tobacco and cannabis use and co-use predict lung function: A longitudinal study. Respir Med 2023; 208:107124. [PMID: 36682602 DOI: 10.1016/j.rmed.2023.107124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Use of tobacco and cannabis is common and has been reported to predict lung function. Less is known about co-use of tobacco and cannabis and their impact on changes in lung function to early adulthood. RESEARCH QUESTION The study examines whether cigarette smoking or cannabis use and co-use are each associated with lung function in a population sample of young adults. STUDY DESIGN AND METHODS Data are from a prospective cohort study of cigarette smoking, cannabis use and co-use at 21 and 30 years of age and lung function (FVC, FEV1, FEV1/FVC) measured at 30 years. Lung function results are transformed using Global Lung Function Formulae. Subjects are the children of pregnant women who were recruited into the cohort study over the period 1981-3. Respondents were administered a spirometry assessment at 21 and 30 years of age. These respondents completed a smoking and cannabis use questionnaire at 21- and 30-year follow-ups. RESULTS Cigarette smoking (with or without cannabis use) is associated with reduced airflow. There is no consistent association between cannabis use and measures of lung function. The co-use of tobacco and cannabis appears to entail no additional risk to lung function beyond the risks associated with tobacco use alone. INTERPRETATION Persistent cigarette smoking is associated with reduced airflow even in young adults. Cannabis use does not appear to be related to lung function even after years of use.
Collapse
Affiliation(s)
- Jake M Najman
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia.
| | - Scott Bell
- Children's Health Research Centre, Faculty of Medicine, University of Queensland, Graham Road, South Brisbane, Qld, 4101, Australia
| | - Gail M Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia
| | - Alexandra M Clavarino
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia
| | - James G Scott
- Child & Youth Mental Health, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Qld, 4006, Australia
| | - Tara R McGee
- School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mount Gravatt, Qld, 4122, Australia
| | - Abdullah A Mamun
- UQ Poche Centre for Indigenous Health, The University of Queensland, 74 High Street, Toowong, Qld, 4066, Australia
| |
Collapse
|
23
|
Shah S, Schwenk ES, Sondekoppam RV, Clarke H, Zakowski M, Rzasa-Lynn RS, Yeung B, Nicholson K, Schwartz G, Hooten WM, Wallace M, Viscusi ER, Narouze S. ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids. Reg Anesth Pain Med 2023; 48:97-117. [PMID: 36596580 DOI: 10.1136/rapm-2022-104013] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear. METHODS In November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids. A consensus recommendation required ≥75% agreement. RESULTS Nine questions were selected, with 100% consensus achieved on third-round voting. Topics addressed included perioperative screening, postponement of elective surgery, concomitant use of opioid and cannabis perioperatively, implications for parturients, adjustment in anesthetic and analgesics intraoperatively, postoperative monitoring, cannabis use disorder, and postoperative concerns. Surgical patients using cannabinoids are at potential increased risk for negative perioperative outcomes. CONCLUSIONS Specific clinical recommendations for perioperative management of cannabis and cannabinoids were successfully created.
Collapse
Affiliation(s)
- Shalini Shah
- Dept of Anesthesiology & Perioperative Care, UC Irvine Health, Orange, California, USA
| | - Eric S Schwenk
- Anesthesiology and Perioperative Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Hance Clarke
- Anesthesiology and Pain Medicine, Univ Toronto, Toronto, Ontario, Canada
| | - Mark Zakowski
- Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - Brent Yeung
- Anesthesiology and Perioperative Care, University of California Irvine, Irvine, California, USA
| | | | - Gary Schwartz
- AABP Integrative Pain Care, Melville, New York, USA.,Anesthesiology, Maimonides Medical Center, Brooklyn, New York, USA
| | | | - Mark Wallace
- Anesthesiology, Division of Pain Medicine, University of California San Diego, La Jolla, California, USA
| | - Eugene R Viscusi
- Anesthesiology and Perioperative Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Samer Narouze
- Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, Ohio, USA
| |
Collapse
|
24
|
Lisano JK, Flores VA, Kisiolek JN, Stewart LK. Regular Use of Cannabis in Female Athletes Is Associated With a Reduction in Early Anaerobic Power Production. J Strength Cond Res 2023; 37:616-622. [PMID: 36820704 DOI: 10.1519/jsc.0000000000004297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
ABSTRACT Lisano, JK, Flores, VA, Kisiolek, JN, and Stewart, LK. Regular use of cannabis in female athletes is associated with a reduction in early anaerobic power production. J Strength Cond Res 37(3): 616-622, 2023-Despite a growing number of claims related to the ability of cannabis use to affect health and performance, there is limited research available, especially in female athletes. This cross-sectional study aimed to determine whether chronic cannabis use in physically active female athletes is related to altered health and performance. Healthy, physically active, female cannabis users (CU: n = 12) and noncannabis users (NU: n = 12) with an average age of 23.8 ± 3.7 years and 19.3 ± 4.2% body fat completed athletic performance and health assessments. Significance was set at alpha = 0.05. The age of onset of regular cannabis use was 20.1 ± 2.8 years in CU with an average duration of cannabis use of 5.8 ± 3.1 years. There were no differences between groups with respect to body size, body composition, pulmonary function, cardiorespiratory function, or muscular strength. Cannabis users produced significantly less power in the first 2 stages of the Wingate assessment, but CU experienced significantly less anaerobic fatigue. Although body composition and cardiovascular fitness were comparable, average C-reactive protein concentration classified CU with higher risk for cardiovascular disease (CVD). Athletes and coaches who rely heavily on anaerobic performance should consider these findings because they indicate that regular cannabis use may affect early power production and CVD risk.
Collapse
Affiliation(s)
- Jonathon K Lisano
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorado
| | | | | | | |
Collapse
|
25
|
Corso B, Bacle A, Demay E, Mercerolle M, Pelletier R, Gicquel T, Le Daré B. Place of therapeutic cannabis in France and safety data: A literature review. ANNALES PHARMACEUTIQUES FRANÇAISES 2023:S0003-4509(23)00021-4. [PMID: 36841395 DOI: 10.1016/j.pharma.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES To date, very few cannabis-based specialities are authorised on the French market despite a growing demand from patients and health professionals. The objective of this study is to review the tolerance profile and the French legislative status of the two main cannabinoids used for therapeutic purposes: tetrahydrocannabiol (THC) associated with psychoactive effects and non-psychoactive cannabidiol (CBD). METHODS This review is based on relevant articles retrieved by a search in Google Scholar and PubMed databases and on an assessment of the legal texts and summaries of product characteristics available in France. RESULTS Evidence for the tolerability of CBD during chronic use is reassuring, but a significant risk of drug interactions exists. THC use appears to be associated with a higher proportion of serious adverse effects, including neuropsychological and cardiovascular effects. Inhaled cannabis appears to be associated with greater toxicity than the oral route. These data are presented together with the pharmacokinetic and pharmacodynamic data of THC and CBD. CONCLUSION The literature reports several frequent but rarely serious adverse effects of CBD during chronic use as well as a significant risk of drug interactions. THC use seems to be associated with a higher proportion of serious adverse effects compared to CBD, particularly at the neuropsychological and cardiovascular levels. Health professionals should be up to date on the particularities of therapeutic cannabis in terms of efficacy, safety and drug interactions.
Collapse
Affiliation(s)
- B Corso
- Université de Rennes 1, 35000 Rennes, France
| | - A Bacle
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France
| | - E Demay
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France
| | - M Mercerolle
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France
| | - R Pelletier
- Centre hospitalier universitaire de Rennes, laboratoire de toxicologie biologique et médico-légale, biochimie-toxicologie, 35000 Rennes, France; Université Rennes, Inserm, INRAE, CHU de Rennes, Institut NuMeCan (Nutrition, Métabolismes et Cancer), Réseau PREVITOX, 35000 Rennes, France
| | - T Gicquel
- Centre hospitalier universitaire de Rennes, laboratoire de toxicologie biologique et médico-légale, biochimie-toxicologie, 35000 Rennes, France; Université Rennes, Inserm, INRAE, CHU de Rennes, Institut NuMeCan (Nutrition, Métabolismes et Cancer), Réseau PREVITOX, 35000 Rennes, France
| | - B Le Daré
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France; Université Rennes, Inserm, INRAE, CHU de Rennes, Institut NuMeCan (Nutrition, Métabolismes et Cancer), Réseau PREVITOX, 35000 Rennes, France.
| |
Collapse
|
26
|
Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
Collapse
Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
| |
Collapse
|
27
|
Alanazi AMM, Alqahtani MM, Alquaimi MM, Alotaibi TF, Algarni SS, Alonizi KM, Ismaeil TT, Gibson-Young L, Jayawardene WP. Epidemiological associations of asthma status and tobacco use, substance use, and substance misuse among adults in the United States, 2015-2019. J Asthma 2023; 60:87-95. [PMID: 35025703 DOI: 10.1080/02770903.2022.2029480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: Adults with asthma have a higher prevalence of substance use. However, knowledge is scarce regarding the associations between adults with asthma and tobacco use, substance use, and substance misuse. This study aimed to use national samples of United States adults to assess the comprehensive use and misuse of substances in adults with asthma.Method: This cross-sectional study comprised data drawn from the 2015 to 2019 National Survey on Drug Use and Health. Weighted logistic regressions were used to measure the associations of asthma status (lifetime and current) with last month's tobacco use; substance use (alcohol, marijuana, cocaine, crack, heroin, hallucinogens, inhalants); and substance misuse (pain relievers, tranquilizers, stimulants, sedatives). All regression models were controlled for sociodemographic characteristics, comorbidity, last-month serious psychological distress, and co-substance use and misuse. Results: Adults with lifetime asthma (Nweighted = 115,600,887) were less likely to use cigarettes, cigars, smokeless tobacco, inhalants, and polyuse of any substance. In contrast, adults with current asthma (Nweighted = 765,096,31) were more likely to use pipe tobacco, cocaine, non-prescribed tranquilizers, and less likely to use polytobacco products. Adults with lifetime asthma were associated with fewer last-month tobacco and inhalant use than those without lifetime asthma. However, adults with current asthma were associated with greater last month's pipe tobacco, cocaine, and non-prescribed tranquilizers. Conclusion: Thus, further longitudinal studies are recommended among adults with asthma to effectively design tailored treatment and prevention interventions.
Collapse
Affiliation(s)
- Abdullah M M Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed M Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Maher M Alquaimi
- Department of Respiratory Therapy, College of Applied Medical Sciences, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Tareq F Alotaibi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Saleh S Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Khalid M Alonizi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Respiratory Services, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Taha T Ismaeil
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Wasantha P Jayawardene
- Institute for Research on Addictive Behavior, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| |
Collapse
|
28
|
Murtha L, Sathiadoss P, Salameh JP, Mcinnes MDF, Revah G. Chest CT Findings in Marijuana Smokers. Radiology 2022; 307:e212611. [PMID: 36378033 DOI: 10.1148/radiol.212611] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Global consumption of marijuana is increasing, but there is a paucity of evidence concerning associated lung imaging findings. Purpose To use chest CT to investigate the effects of marijuana smoking in the lung. Materials and Methods This retrospective case-control study evaluated results of chest CT examinations (from October 2005 to July 2020) in marijuana smokers, nonsmoker control patients, and tobacco-only smokers. We compared rates of emphysema, airway changes, gynecomastia, and coronary artery calcification. Age- and sex-matched subgroups were created for comparison with tobacco-only smokers older than 50 years. Results were analyzed using χ2 tests. Results A total of 56 marijuana smokers (34 male; mean age, 49 years ± 14 [SD]), 57 nonsmoker control patients (32 male; mean age, 49 years ± 14), and 33 tobacco-only smokers (18 male; mean age, 60 years ± 6) were evaluated. Higher rates of emphysema were seen among marijuana smokers (42 of 56 [75%]) than nonsmokers (three of 57 [5%]) (P < .001) but not tobacco-only smokers (22 of 33 [67%]) (P = .40). Rates of bronchial thickening, bronchiectasis, and mucoid impaction were higher among marijuana smokers compared with the other groups (P < .001 to P = .04). Gynecomastia was more common in marijuana smokers (13 of 34 [38%]) than in control patients (five of 32 [16%]) (P = .039) and tobacco-only smokers (two of 18 [11%]) (P = .040). In age-matched subgroup analysis of 30 marijuana smokers (23 male), 29 nonsmoker control patients (17 male), and 33 tobacco-only smokers (18 male), rates of bronchial thickening, bronchiectasis, and mucoid impaction were again higher in the marijuana smokers than in the tobacco-only smokers (P < .001 to P = .006). Emphysema rates were higher in age-matched marijuana smokers (28 of 30 [93%]) than in tobacco-only smokers (22 of 33 [67%]) (P = .009). There was no difference in rate of coronary artery calcification between age-matched marijuana smokers (21 of 30 [70%]) and tobacco-only smokers (28 of 33 [85%]) (P = .16). Conclusion Airway inflammation and emphysema were more common in marijuana smokers than in nonsmokers and tobacco-only smokers, although variable interobserver agreement and concomitant cigarette smoking among the marijuana-smoking cohort limits our ability to draw strong conclusions. © RSNA, 2022 See also the editorial by Galvin and Franks in this issue.
Collapse
Affiliation(s)
- Luke Murtha
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Paul Sathiadoss
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Jean-Paul Salameh
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Matthew D. F. Mcinnes
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Giselle Revah
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| |
Collapse
|
29
|
Abstract
Human beings have used marijuana products for centuries. Relatively recent data showing extensive cannabinoid receptors, particularly in the brain, help to explain the impacts of cannabinoids on symptoms/diseases, such as pain and seizures, with major nervous system components. Marijuana can cause bronchitis, but a moderate body of literature suggests that distal airway/parenchymal lung disease does not occur; marijuana does not cause chronic obstructive pulmonary disease and probably does not cause lung cancer, distinctly different from tobacco. Potentials for cognitive impairment and for damage to the developing brain are contextually important as its beneficial uses are explored.
Collapse
Affiliation(s)
- Manish Joshi
- Pulmonary and Critical Care Division, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, USA; Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA.
| | - Anita Joshi
- Department of Epidemiology, Fay W. Boozman College Public Health, University of Arkansas for Medical Sciences, 4300 West Markham, Little Rock, AR 72205, USA
| | - Thaddeus Bartter
- Pulmonary and Critical Care Division, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, USA; Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
| |
Collapse
|
30
|
Pradère P, Ruppert AM, Peiffer G, Perriot J, Adler M, Underner M. [Inhaled marijuana and the lung, a toxic cocktail?]. Rev Mal Respir 2022; 39:708-718. [PMID: 36115751 DOI: 10.1016/j.rmr.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/28/2022]
Abstract
Unlike the well-documented effects of tobacco smoke on the lung, the effects of cannabis smoke remain controversial, the main bias consisting in co-consumption of tobacco. That said, the composition of joint smoke is close to that of cigarettes, containing many compounds that are carcinogenic and/or alter the respiratory epithelium. Confirmed respiratory effects in chronic cannabis smokers include aggravated chronic bronchitis symptoms, a cumulative effect with tobacco on COPD and emphysema occurrence, an increased risk of bullous emphysema, and pneumothorax with heightened risk of recurrence after pleural symphysis. Recent prospective studies have shown a negative impact on lung function, with not only damage to the airways, but also DLCO alteration and an accelerated drop in FEV1. Finally, cannabis smoking is very common among young patients with lung cancer. Its consumption could lead to a different lung cancer profile, potentially more undifferentiated and less accessible to targeted therapy. Questioning about cannabis consumption must be systematic and targeted medical care should be offered.
Collapse
Affiliation(s)
- P Pradère
- Service de pneumologie, hôpital Marie Lannelongue, université Paris Saclay, groupe hospitalier Paris Saint Joseph, 92350 Le Plessis Robinson, France.
| | - A M Ruppert
- Sorbonne-université GRC04 Theranoscan, unité de tabacologie, service de pneumologie et oncologie thoracique, hôpital Tenon, APHP, Paris, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, Metz, France
| | - J Perriot
- Dispensaire Emile Roux, centre de tabacologie, Clermont-Ferrand, France
| | - M Adler
- Unité de tabacologie, hôpital Antoine Béclère, Clamart, France
| | - M Underner
- Unite de recherche clinique, centre hospitalier Henri Laborit, université de Poitiers, Poitiers, France
| |
Collapse
|
31
|
Dahlgren MK, El-Abboud C, Lambros AM, Sagar KA, Smith RT, Gruber SA. A survey of medical cannabis use during perimenopause and postmenopause. Menopause 2022; 29:1028-1036. [PMID: 35917529 PMCID: PMC9422771 DOI: 10.1097/gme.0000000000002018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Expanding access to legal cannabis has dovetailed with increased interest in medical cannabis (MC) use; however, there is a paucity of research examining MC use to alleviate menopause-related symptoms. This survey study assessed patterns of MC use in perimenopausal and postmenopausal individuals. METHODS Participants (perimenopausal, n = 131; postmenopausal, n = 127) completed assessments of menopause-related symptomatology and cannabis use, including modes of use, type of use, and menopause-related symptoms addressed by MC use. RESULTS Most participants reported current cannabis use (86.1%) and endorsed using MC for menopause-related symptoms (78.7%). The most common modes of use were smoking (84.3%) and edibles (78.3%), and the top menopause-related symptoms for MC use were sleep disturbance (67.4%) and mood/anxiety (46.1%). Relative to postmenopausal participants, perimenopausal participants reported significantly worse menopause-related symptomatology on the vasomotor and psychosocial subscales of the Menopause-Specific Quality of Life Questionnaire ( P s ≤ 0.04), including greater burden of anxiety ( P = 0.01) and hot flash ( P = 0.04) symptoms. In addition, perimenopausal participants reported higher incidence of depression ( P = 0.03) and anxiety diagnoses ( P < 0.01), as well as increased use of MC to treat menopause-related mood/anxiety symptoms relative to postmenopausal participants ( P = 0.01). CONCLUSIONS Results suggest that many individuals are currently using MC as an adjunctive treatment for menopause-related symptoms, particularly sleep disturbance and mood/anxiety. Future research should examine the impact of different MC use characteristics (e.g., cannabinoid profiles) on the efficacy of MC use for menopause-related symptoms. Increased severity and prevalence of mood and anxiety symptoms in perimenopausal participants suggest promising targets for clinical trials of cannabinoid-based therapies.
Collapse
Affiliation(s)
- M. Kathryn Dahlgren
- From the Cognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, Belmont, MA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Celine El-Abboud
- From the Cognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, Belmont, MA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, MA
| | - Ashley M. Lambros
- From the Cognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, Belmont, MA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, MA
| | - Kelly A. Sagar
- From the Cognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, Belmont, MA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Rosemary T. Smith
- From the Cognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, Belmont, MA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, MA
| | - Staci A. Gruber
- From the Cognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, Belmont, MA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| |
Collapse
|
32
|
Tashkin DP, Tan WC. Inhaled Marijuana and the Lung. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2822-2829. [PMID: 35609784 DOI: 10.1016/j.jaip.2022.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
Although vaping has recently increased as a mode of inhaling marijuana and has been associated with numerous and sometimes fatal cases of acute severe lung injury, smoking remains the most common method of inhaling marijuana and has been studied more extensively. Smoking marijuana has been shown to produce modest but significant short-term bronchodilation both in healthy subjects and those with asthma. Long-term effects of habitual marijuana smoking include the following: 1) symptoms of chronic bronchitis (increased cough, sputum production and wheezing); 2) modest effects on lung function in cross-sectional studies (no significant decrease in forced expired volume in 1 second [FEV1) but mild reductions in FEV1/forced vital capacity ratio [FEV1/FVC], an increase in FVC and other lung volumes, reductions in specific airway conductance, and variable effects of maximal mid-expiratory flow rates and diffusing capacity; and 3) variable effects on age-related decline in FEV1 in longitudinal studies. Most cohort and case-control studies have failed to show that marijuana smoking is a significant risk-factor for lung cancer despite the presence of pro-carcinogenic components in marijuana smoke, although further study is warranted. The question whether marijuana smoking is associated with asthma is unclear and requires further investigation. Although delta-9 tetrahydrocannabinol (THC), the principal psychoactive component of marijuana, has immunomodulatory properties that hypothetically could increase the risk of pneumonia, the few available studies in marijuana smokers have failed to find an increased risk of pneumonia in immunocompetent users, although effects in immunosuppressed individuals have been variable.
Collapse
Affiliation(s)
- Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA Health Sciences, Los Angeles, CA 90095, USA
| | - Wan-Cheng Tan
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, V6Z 1Y6, Canada
| |
Collapse
|
33
|
Hancox RJ, Gray AR, Zhang X, Poulton R, Moffitt TE, Caspi A, Sears MR. Differential Effects of Cannabis and Tobacco on Lung Function in Mid-Adult Life. Am J Respir Crit Care Med 2022; 205:1179-1185. [PMID: 35073503 PMCID: PMC9872808 DOI: 10.1164/rccm.202109-2058oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Rationale: Evidence suggests that the effects of smoking cannabis on lung function are different from tobacco. However, long-term follow-up data are scarce and mostly based on young adults. Objectives: To assess the effects of cannabis and tobacco on lung function in mid-adult life. Methods: Cannabis and tobacco use were reported at ages 18, 21, 26, 32, 38, and 45 years in a population-based cohort study of 1,037 participants. Spirometry, plethysmography, and carbon monoxide transfer factor were measured at age 45. Associations between lung function and cannabis use were adjusted for tobacco use. Measurements and Main Results: Data were available from 881 (88%) of 997 surviving participants. Cumulative cannabis use was associated with lower FEV1/FVC ratios, owing to a tendency toward higher FVCs. Cannabis use was also associated with higher TLC, FRC, residual volume, and Va along with lower midexpiratory flows, airway conductance, and transfer factor. Quitting regular cannabis use between assessments was not associated with changes in spirometry. Conclusions: Cannabis use is associated with higher lung volumes, suggesting hyperinflation. There is evidence of increased large-airway resistance and lower midexpiratory airflow, but impairment of FEV1/FVC ratio is because of higher FVC. This pattern of effects is different to those of tobacco. We provide the first evidence that lifetime cannabis use may be associated with impairment of gas transfer.
Collapse
Affiliation(s)
- Robert J. Hancox
- Department of Preventive and Social Medicine, Dunedin School of Medicine
| | | | - Xian Zhang
- Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience,,Department of Psychiatry and Behavioral Sciences, and,Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina; and
| | - Avshalom Caspi
- Department of Psychology and Neuroscience,,Department of Psychiatry and Behavioral Sciences, and,Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina; and
| | - Malcolm R. Sears
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
34
|
Tashkin DP, Barjaktarevic I. How Differential Are the Effects of Smoking Cannabis versus Tobacco on Lung Function? Am J Respir Crit Care Med 2022; 205:1136-1138. [PMID: 35213297 PMCID: PMC9872797 DOI: 10.1164/rccm.202201-0062ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
35
|
Tan HS, McAnally HM, Dummer J, Hancox RJ. Lifetime cannabis exposure and small airway function in a population-based cohort study. ERJ Open Res 2022; 8:00688-2021. [PMID: 35509440 PMCID: PMC9062301 DOI: 10.1183/23120541.00688-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/04/2022] [Indexed: 11/08/2022] Open
Abstract
Background and objective The long-term effects of cannabis on small airway function remain unclear. We investigated associations between cannabis use and small airway function in a general population sample. Methods Cannabis use was ascertained at multiple ages from age 18 to 45 years and quantified as joint-years among 895 participants in the Dunedin Multidisciplinary Health and Development Study. Small airway function at ages 38 and 45 years was measured using impulse oscillometry (IOS) before and after inhalation of salbutamol. Analyses used multiple linear regression adjusting for tobacco use, body mass index and height. Longitudinal analyses of cannabis use between 38 and 45 years also adjusted for IOS at age 38 years. Results Associations between lifetime cannabis joint-years and IOS differed between men and women: in women, cannabis use was associated with pre-bronchodilator resistance at 5 Hz (R5) and 20 Hz (R20), reactance at 5 Hz, area of reactance and resonant frequency, and marginally associated with the difference between R5 and R20. Cannabis use was only statistically significantly associated with pre-bronchodilator resonant frequency in men. Cannabis use between the ages of 38 and 45 years was associated with a similar pattern of changes in IOS measures. After salbutamol, cannabis use was only statistically significantly associated with R5 and R20 among women and none of the IOS measures among men. Conclusions Cannabis use is associated with small airway dysfunction at age 45 years, indicating an increase in peripheral airway resistance and reactance. These associations were greater and mostly only statistically significant among women. Associations were weaker and mostly nonsignificant after bronchodilator use, suggesting that cannabis-induced changes in small airways may be at least partially reversible. Lifetime cannabis exposure is associated with measures of small airway dysfunction indicating higher small airway resistance and greater reactancehttps://bit.ly/3pWnZTu
Collapse
|
36
|
Schleimer JP, Smith N, Zaninovic V, Keyes KM, Castillo-Carniglia A, Rivera-Aguirre A, Cerdá M. Trends in the sequence of initiation of alcohol, tobacco, and marijuana use among adolescents in Argentina and Chile from 2001 to 2017. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103494. [PMID: 34666217 DOI: 10.1016/j.drugpo.2021.103494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/08/2021] [Accepted: 10/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Variation in drug policies, norms, and substance use over time and across countries may affect the normative sequences of adolescent substance use initiation. We estimated relative and absolute time-varying associations between prior alcohol and tobacco use and adolescent marijuana initiation in Argentina and Chile. Relative measures quantify the magnitude of the associations, whereas absolute measures quantify excess risk. METHODS We analyzed repeated, cross-sectional survey data from the National Surveys on Drug Use Among Secondary School Students in Argentina (2001-2014) and Chile (2001-2017). Participants included 8th, 10th, and 12th grade students (N = 680,156). Linear regression models described trends over time in the average age of first use of alcohol, tobacco, and marijuana. Logistic regression models were used to estimate time-varying risk ratios and risk differences of the associations between prior alcohol and tobacco use and current-year marijuana initiation. RESULTS Average age of marijuana initiation increased and then decreased in Argentina and declined in Chile. In both countries, the relative associations between prior tobacco use and marijuana initiation weakened amid declining rates of tobacco use; e.g., in Argentina, the risk ratio was 19.9 (95% CI: 9.0-30.8) in 2001 and 11.6 (95% CI: 9.0-13.2) in 2014. The relative association between prior alcohol use and marijuana initiation weakened Chile, but not in Argentina. On the contrary, risk differences (RD) increased substantially across both relationships and countries, e.g., in Argentina, the RD for tobacco was 3% (95% CI: 0.02-0.03) in 2001 and 12% (95% CI: 0.11-0.13) in 2014. CONCLUSION Diverging trends in risk ratios and risk differences highlight the utility of examining multiple measures of association. Variation in the strength of the associations over time and place suggests the influence of environmental factors. Increasing risk differences indicate alcohol and tobacco use may be important targets for interventions to reduce adolescent marijuana use.
Collapse
Affiliation(s)
- Julia P Schleimer
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine, 2315 Stockton Blvd., Sacramento, CA 95817, USA.
| | - Nathan Smith
- Department of Psychology, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
| | - ViniNatalie Zaninovic
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St. NY, NY 10032, New York, NY, USA
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Badajoz 130, Las Condes, Santiago, Chile; School of Public Health, Universidad Mayor, Jose Toribio Medina #38, Santiago, Chile; Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| |
Collapse
|
37
|
Ross JM, Ellingson JM, Frieser MJ, Corley RC, Hopfer CJ, Stallings MC, Wadsworth SJ, Reynolds CA, Hewitt JK. The effects of cannabis use on physical health: A co-twin control study. Drug Alcohol Depend 2022; 230:109200. [PMID: 34871975 PMCID: PMC8714702 DOI: 10.1016/j.drugalcdep.2021.109200] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Research on the influence of cannabis use on anthropometrics, cardiovascular and pulmonary function, and other indicators of physical health has reported mixed results. We examined whether cannabis frequency is associated with physical health outcomes phenotypically and after controlling for shared genetic and environmental factors via a longitudinal co-twin control design. METHODS We tested the phenotypic associations of adolescent, young adult, and adult cannabis frequency with adult physical health. Next, we ran multilevel models to test if significant phenotypic associations remained at the between-family and within-twin pair levels. Participants include 677 individual twins (308 twin pairs) aged 25-35. RESULTS At the phenotypic level, adolescent cannabis use was associated with less adult exercise engagement (b = - 0.846 min, p = .000). Adult cannabis use was associated with a lower resting heart rate (HR; b = - 0.170 bpm, p = .001) and more frequent appetite loss (b = 0.018, p = .000). Only between-family effects were significant for adolescent cannabis use and exercise engagement (b = - 1.147 min, p = .000) and adult cannabis use and appetite loss frequency (b = 0.041, p = .002). The total within-twin (b = - 0.184, p = .014), MZ only (b = - 0.304, p = .003), and between-family effects (b = - 0.164, p = .025) were significant between adult cannabis use and a lower resting HR, which persisted after controlling for familial confounds and other substance use. CONCLUSIONS The associations between cannabis use with exercise engagement and frequency of appetite loss are explained by familial confounding while the association between cannabis use and resting HR was not. These results do not support a causal association between cannabis use once a week and poorer physical health effects among adults aged 25-35.
Collapse
Affiliation(s)
- J. Megan Ross
- Department of Psychiatry, University of Colorado Anschutz Medical Campus
| | | | | | - Robin C. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - Michael C. Stallings
- Institute for Behavioral Genetics, University of Colorado Boulder,Department of Psychology and Neuroscience, University of Colorado Boulder
| | | | | | - John K. Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder,Department of Psychology and Neuroscience, University of Colorado Boulder
| |
Collapse
|
38
|
Applications of Cannabis Sativa L. in Food and Its Therapeutic Potential: From a Prohibited Drug to a Nutritional Supplement. Molecules 2021; 26:molecules26247699. [PMID: 34946779 PMCID: PMC8708517 DOI: 10.3390/molecules26247699] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/07/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Hemp (Cannabis sativa L.) is a herbaceous anemophilous plant that belongs to the Cannabinaceae family. The cannabis seed (hemp) has long been utilized as a food source and is commercially important as an edible oil source. In this review, the positive and negative health effects of cannabis, the relationship between cannabis and various diseases, and the use of cannabis in various food products have been discussed. In addition, the scientific literature on the potential use of cannabis and its derivatives as a dietary supplement for the prevention and treatment of inflammatory and chronic degenerative diseases in animals and humans has been reviewed. Cannabis is being developed as a key ingredient in a variety of food items, including bakery, confectionery, beverages, dairy, fruits, vegetables, and meat. Hemp seeds are high in readily digestible proteins, lipids, polyunsaturated fatty acids (PUFA), insoluble fiber, carbs, and favorable omega-6 PUFA acid to omega-3 PUFA ratio and have high nutritional value. The antioxidants of cannabis, such as polyphenols, help with anxiety, oxidative stress, and the risk of chronic illnesses, including cancer, neurological disorders, digestive problems, and skin diseases. Cannabis has been shown to have negative health impacts on the respiratory system, driving, and psychomotor functions, and the reproductive system. Overall, the purpose of this research is to stimulate more in-depth research on cannabis's adaptation in various foods and for the treatment of chronic illnesses.
Collapse
|
39
|
Datta S, Ramamurthy PC, Anand U, Singh S, Singh A, Dhanjal DS, Dhaka V, Kumar S, Kapoor D, Nandy S, Kumar M, Koshy EP, Dey A, Proćków J, Singh J. Wonder or evil?: Multifaceted health hazards and health benefits of Cannabis sativa and its phytochemicals. Saudi J Biol Sci 2021; 28:7290-7313. [PMID: 34867033 PMCID: PMC8626265 DOI: 10.1016/j.sjbs.2021.08.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022] Open
Abstract
Cannabis sativa, widely known as 'Marijuana' poses a dilemma for being a blend of both good and bad medicinal effects. The historical use of Cannabis for both medicinal and recreational purposes suggests it to be a friendly plant. However, whether the misuse of Cannabis and the cannabinoids derived from it can hamper normal body physiology is a focus of ongoing research. On the one hand, there is enough evidence to suggest that misuse of marijuana can cause deleterious effects on various organs like the lungs, immune system, cardiovascular system, etc. and also influence fertility and cause teratogenic effects. However, on the other hand, marijuana has been found to offer a magical cure for anorexia, chronic pain, muscle spasticity, nausea, and disturbed sleep. Indeed, most recently, the United Nations has given its verdict in favour of Cannabis declaring it as a non-dangerous narcotic. This review provides insights into the various health effects of Cannabis and its specialized metabolites and indicates how wise steps can be taken to promote good use and prevent misuse of the metabolites derived from this plant.
Collapse
Affiliation(s)
- Shivika Datta
- Department of Zoology, Doaba College, Jalandhar, Punjab 144001, India
| | - Praveen C. Ramamurthy
- Interdisciplinary Centre for Water Research (ICWaR), Indian Institute of Sciences, Bangalore 560012, Karnataka, India
| | - Uttpal Anand
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Simranjeet Singh
- Interdisciplinary Centre for Water Research (ICWaR), Indian Institute of Sciences, Bangalore 560012, Karnataka, India
| | - Amritpal Singh
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College and Hospital, Amphala, Jammu 180012, India
| | - Daljeet Singh Dhanjal
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Vaishali Dhaka
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Sanjay Kumar
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Miyagi 980-8577, Japan
| | - Dhriti Kapoor
- Department of Botany, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Samapika Nandy
- Department of Life Sciences, Presidency University, Kolkata 700073, West Bengal, India
| | - Manoj Kumar
- Department of Life Sciences, School of Natural Science, Central University of Jharkhand, Brambe, Ratu-Lohardaga Road Ranchi, Jharkhand 835205, India
| | - Eapen P. Koshy
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata 700073, West Bengal, India
| | - Jarosław Proćków
- Department of Plant Biology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Kożuchowska 5b, 51-631 Wrocław, Poland
| | - Joginder Singh
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| |
Collapse
|
40
|
Kaplan AG. Cannabis and Lung Health: Does the Bad Outweigh the Good? Pulm Ther 2021; 7:395-408. [PMID: 34697771 PMCID: PMC8589923 DOI: 10.1007/s41030-021-00171-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/12/2021] [Indexed: 11/24/2022] Open
Abstract
Cannabis use is growing, with multiple medical ‘indications’ and approval for recreational use in many countries. This article will review some of the respiratory complications to cannabis use, which include lung function changes, lung destruction, increased risk of lung and head and neck cancer, and others. These are mostly related to smoking, and the co-administration of nicotine makes the risks a bit difficult to measure. However, with many reports of EVALI, electronic vaping-associated lung injury, being related to cannabis coadministration, it appears that the safest administration of cannabis, as far as lung health, is orally. Cannabis and Lung Health: Does the Bad Outweigh the Good? A video abstract (MP4 81,897 kb)
Collapse
Affiliation(s)
- Alan G Kaplan
- Family Physician Airways Group of Canada, Respiratory Effectiveness Group, Primary Care Respiratory Research, OPRI, local LHIN Pulmonary Rehabilitation Clinics, University of Toronto, 7335 Yonge Street, Thornhill, Toronto, ON, L3T 2B2, Canada.
| |
Collapse
|
41
|
Vakharia RM, Mannino A, Salem HS, Roche MW, Wong CHJ, Mont MA. The association between cannabis use disorder and the outcome following primary total hip arthroplasty : analysis of a nationwide administrative claims database. Bone Joint J 2021; 103-B:111-115. [PMID: 34192906 DOI: 10.1302/0301-620x.103b7.bjj-2020-2424.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Although there is increasing legalization of the use of cannabis in the USA, few well-powered studies have evaluated the association between cannabis use disorder and outcomes following primary total hip arthroplasty (THA). Thus, the aim of this study was to determine whether patients who use cannabis and undergo primary THA have higher rates of in-hospital length of stay (LOS), medical complications, implant-related complications, and costs. METHODS Using an administrative database, patients with cannabis use disorder undergoing primary THA were matched to a control group in a 1:5 ratio by age, sex, and various medical comorbidities. This yielded 23,030 patients (3,842 in the study group matched with 19,188 in the control group). The variables which were studied included LOS, 90-day medical complications, two-year implant-related complications, and 90-day costs of care. Mann-Whitney U tests were used to compare LOS and costs. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of developing complications. RESULTS We found that patients in the study group had a significantly longer mean LOS compared with the controls (four days vs three days; p < 0.0001).The study group also had a significantly higher incidence and odds of developing medical (23.0 vs 9.8%, OR 1.6; p < 0.0001) and implant-related complications (16 vs 7.4%, OR 1.6; p < 0.0001) and incurred significantly higher mean 90-day costs ($16,938.00 vs $16,023.00; p < 0.0001). CONCLUSION With the increasing rates of cannabis use, these findings allow orthopaedic surgeons and other healthcare professionals to counsel patients with cannabis use disorder about the possible outcomes following their THA, with increased hospital stays, complications, and costs. Cite this article: Bone Joint J 2021;103-B(7 Supple B):111-115.
Collapse
Affiliation(s)
- Rushabh M Vakharia
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA
| | - Angelo Mannino
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA
| | - Hytham S Salem
- Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, New York, USA
| | - Martin W Roche
- Department of Orthopaedic Surgery, Hospital for Special Surgery, West Palm Beach, Florida, USA
| | - Che Hang J Wong
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA
| | - Michael A Mont
- Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, New York, USA.,Department of Orthopaedic Surgery, Cleveland Clinic Hospital, Cleveland, Ohio, USA
| |
Collapse
|
42
|
Toquet S, Cousson J, Choiselle N, Gozalo C, Giusti D, Bani-Sadr F, N'Guyen Y. Alveolar hemorrhage due to marijuana smoking using water pipe made with plastic bottle: case report and narrative review of the literature. Inhal Toxicol 2021; 33:168-176. [PMID: 34180335 DOI: 10.1080/08958378.2021.1939465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION We described a case of alveolar hemorrhage (AH) after marijuana smoking using a water pipe made with plastic bottle (bong) before making a narrative review of the literature. CASE REPORT A 19-year-old male was admitted for hemoptysis and dyspnea evolving since the previous day. He smoked marijuana ten times a day using bongs. Computed tomography scan of the chest (chest CT-scan) evidenced ground glass opacities involving upper lobes with crazy-paving pattern. Bronchoalveolar lavage (BAL) yielded fluid becoming progressively bloody suggestive of AH. Screening of drug metabolites ruled out the presence of cocaine degradation products. Treatment with prednisone was prescribed and oxygen requirements decreased rapidly. The patient accepted to stop bongs, but kept on smoking marijuana using joints. He was asymptomatic 2 months later; all ground glass opacities had vanished. REVIEW OF THE LITERATURE Four cases described exactly the same circumstances as ours. All were young male patients containing ground glass opacities with diffuse or bilateral pattern in their chest CT-scan. The explanation suggested by the authors of these cases was the potential concomitant inhalation of acid anhydrides derived from use of heated plastic bottle. No acid anhydrides were experimentally evidenced after thermodesorption of heated polyethylene terephthalate (PET) (in which a majority of plastic bottles are made) we performed, but other compounds were. E-cigarette, or vaping, product use-associated lung injuries cases share some chest CT-scan patterns with those of AH following bong use and we tried to draw a parallel between these two latter before discussing a physiopathological hypothesis.
Collapse
Affiliation(s)
- Ségolène Toquet
- Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Joël Cousson
- Unité de Réanimation Polyvalente, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Nathalie Choiselle
- Ecole Nationale Supérieure d'Ingénieurs de Reims ESIREIMS, Université de Reims Champagne Ardennes, Reims, France
| | - Claire Gozalo
- Laboratoire de Pharmacologie, Hôpital Maison Blanche, CHU Reims, Reims, France
| | - Delphine Giusti
- Laboratoire d'Immunologie, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Firouze Bani-Sadr
- Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Yohan N'Guyen
- Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
| |
Collapse
|
43
|
Wakefield CJ, Seder CW, Arndt AT, Geissen N, Liptay MJ, Karush JM. Cannabis Use Is Associated With Recurrence After Primary Spontaneous Pneumothorax. Front Surg 2021; 8:668588. [PMID: 34113644 PMCID: PMC8185055 DOI: 10.3389/fsurg.2021.668588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Primary spontaneous pneumothorax (PSP) is a frequently encountered entity that carries a high rate of recurrence. The current study aims to investigate if cannabis use at time of initial PSP is associated with disease recurrence. Methods: Patients presenting with PSP between 2010 and 2018 at a single institution were identified. Exclusion criteria included secondary pneumothorax, severe chronic lung disease, lung cancer, and lost to follow-up. Patients were compared relative to their cannabis usage with Fisher's exact test, Wilcoxon rank-sum test, and logistic regression. Results: Overall, 67 patients (53 male) met inclusion criteria with a median body mass index (BMI) of 21.5 kg/m2 (IQR 19.1–25.2) and age of 34 years (IQR 22–53). Initial treatment consisted of chest tube in 42 patients (63%), video-assisted thoracoscopic surgery wedge resection in 19 patients (28%), and observation in 6 patients (9%). Cannabis users (n = 28; 42%) had a higher rate of tobacco use (79 vs. 38%; p = 0.005), lower BMI [21.0 kg/m2 (IQR 18.3–23.1) vs. 22.2 kg/m2 (IQR 19.9–28.6), p = 0.037], and were more likely to require intervention at first presentation compared with non-marijuana users. Cannabis use was associated with PSP recurrence when adjusting for tobacco use, BMI, and height (OR 1.85, 95% CI 1.38–18.3, p = 0.014). Conclusion: There is a high rate of cannabis usage in patients presenting with PSP. Cannabis usage is associated with PSP recurrence and eventual need for operative intervention.
Collapse
Affiliation(s)
- Connor J Wakefield
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Christopher W Seder
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Andrew T Arndt
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Nicole Geissen
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Michael J Liptay
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Justin M Karush
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States
| |
Collapse
|
44
|
Gunasekaran K, Voruganti DC, Singh Rahi M, Elango K, Ramalingam S, Geeti A, Kwon J. Trends in Prevalence and Outcomes of Cannabis Use Among Chronic Obstructive Pulmonary Disease Hospitalizations: A Nationwide Population-Based Study 2005-2014. Cannabis Cannabinoid Res 2021; 6:340-348. [PMID: 33998884 DOI: 10.1089/can.2020.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of mortality in the United States. Due to the ongoing legalization of cannabis, its acceptance, availability, and use in the in-patient population are on the rise. In this retrospective study, we investigated the association of cannabis use with important outcomes in COPD hospitalizations. Methods: The National Inpatient Sample (NIS) data were analyzed from 2005 to 2014. The primary outcome of interest was the trends and outcomes of cannabis use among COPD hospitalizations, including in-hospital mortality, pneumonia, sepsis, and respiratory failure. Results: We identified 6,073,862 hospitalizations, 18 years of age or older, with COPD using hospital discharge codes. Of these, 6,049,316 (99.6%) were without cannabis use, and 24,546 (0.4%) were admitted with cannabis use. The majority of COPD hospitalizations with cannabis use were aged 50-64 (60%). Cannabis use was associated with lower odds of in-hospital mortality (odds ratio [OR] 0.624 [95% confidence interval (CI) 0.407-0.958]; p=0.0309) and pneumonia (OR 0.882 [95% CI 0.806-0.964]; p=0.0059) among COPD hospitalizations. Cannabis use also had lower odds of sepsis (OR 0.749 [95% CI 0.523-1.071]; p=0.1127) and acute respiratory failure (OR 0.995 [95% CI 0.877-1.13]; p=0.9411), but it was not statistically significant. Conclusions: Among hospitalized patients with a diagnosis of COPD, cannabis users had statistically significant lower odds of in-hospital mortality and pneumonia compared to noncannabis users. The association between cannabis use and these favorable outcomes deserves further study to understand the interaction between cannabis use and COPD.
Collapse
Affiliation(s)
- Kulothungan Gunasekaran
- Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USA
| | - Dinesh C Voruganti
- Division of Cardiovascular Medicine, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mandeep Singh Rahi
- Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USA
| | - Kalaimani Elango
- Division of Cardiology, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | | | - Adiba Geeti
- Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USA
| | - Jeff Kwon
- Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USA
| |
Collapse
|
45
|
Gracie K, Hancox RJ. Cannabis use disorder and the lungs. Addiction 2021; 116:182-190. [PMID: 32285993 DOI: 10.1111/add.15075] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/04/2020] [Accepted: 03/31/2020] [Indexed: 12/11/2022]
Abstract
Cannabis is one of the world's most widely used recreational drugs and the second most commonly smoked substance. Research on cannabis and the lungs has been limited by its illegal status, the variability in strength and size of cannabis cigarettes (joints), and the fact that most cannabis users also smoke tobacco, making the effects difficult to separate. Despite these difficulties, the available evidence indicates that smoking cannabis causes bronchitis and is associated with changes in lung function. The pattern of effects is surprisingly different from that of tobacco. Whereas smoking cannabis appears to increase the risk of severe bronchitis at quite low exposure, there is no convincing evidence that this leads to chronic obstructive pulmonary disease. Instead, cannabis use is associated with increased central airway resistance, lung hyperinflation and higher vital capacity with little evidence of airflow obstruction or impairment of gas transfer. There are numerous reports of severe bullous lung disease and pneumothorax among heavy cannabis users, but convincing epidemiological data of an increased risk of emphysema or alveolar destruction are lacking. An association between cannabis and lung cancer remains unproven, with studies providing conflicting findings.
Collapse
Affiliation(s)
- Kathryn Gracie
- Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand
| | - Robert J Hancox
- Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand.,Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
46
|
Kaul M, Zee PC, Sahni AS. Effects of Cannabinoids on Sleep and their Therapeutic Potential for Sleep Disorders. Neurotherapeutics 2021; 18:217-227. [PMID: 33580483 PMCID: PMC8116407 DOI: 10.1007/s13311-021-01013-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Abstract
The recent trend for legalization of medicinal cannabis and cannabinoid-containing products, together with their soporific effects, has led to a surge of interest of their potential therapeutic role in the management of some common sleep disorders, such as insomnia, sleep disordered breathing, and restless legs syndrome, and less common disorders such as narcolepsy and parasomnias. Although much of the pre-clinical and clinical data were derived from studies with relatively small sample sizes and limited by biases in assessment, and in clinical trials lack of allocation concealment, as a whole, the results indicate a potential therapeutic role for cannabinoids in the management of some sleep disorders. Clinical trials are underway for insomnia and obstructive sleep apnea management, but there remains a substantial need for rigorous large multi-center studies to assess the dose, efficacy, and safety of the various types of cannabinoids on sleep disorders. This review aims to summarize the modulatory effects of cannabinoids on sleep physiology and provide a critical evaluation of the research on their potential therapeutic benefit in various sleep disorders.
Collapse
Affiliation(s)
- Malvika Kaul
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, 909 S Wolcott Ave, Room 3135 (MC 719), Chicago, IL, 60612, USA
| | - Phyllis C Zee
- Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 305 E. Chicago Ave., Chicago, IL, 60611, USA
| | - Ashima S Sahni
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, 909 S Wolcott Ave, Room 3135 (MC 719), Chicago, IL, 60612, USA.
| |
Collapse
|
47
|
Wenger DS, Triplette M, Shahrir S, Akgun KM, Wongtrakool C, Brown ST, Kim JW, Soo Hoo GW, Rodriguez-Barradas MC, Huang L, Feemster LC, Zifodya J, Crothers K. Associations of marijuana with markers of chronic lung disease in people living with HIV. HIV Med 2020; 22:92-101. [PMID: 33022830 DOI: 10.1111/hiv.12966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The relationship between marijuana use and markers of chronic lung disease in people living with HIV (PLWH) is poorly understood. METHODS We performed a cross-sectional analysis of the Examinations of HIV-Associated Lung Emphysema (EXHALE) study, including 162 HIV-positive patients and 138 participants without HIV. We modelled marijuana exposure as: (i) current daily or weekly marijuana smoking vs. monthly or less often; or (ii) cumulative marijuana smoking (joint-years). Linear and logistic regression estimated associations between marijuana exposure and markers of lung disease, adjusted for tobacco smoking and other factors. RESULTS In PLWH, current daily or weekly marijuana use was associated with a larger forced vital capacity (FVC), larger total lung capacity and increased odds of radiographic emphysema compared with marijuana non-smokers in adjusted models; these associations were not statistically significant in participants without HIV. Marijuana joint-years were associated with higher forced expiratory volume in 1 s and FVC in PLWH but not with emphysema. CONCLUSIONS In PLWH, marijuana smoking was associated with higher lung volumes and potentially with radiographic emphysema. No consistently negative associations were observed between marijuana and measures of chronic lung health.
Collapse
Affiliation(s)
- D S Wenger
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - M Triplette
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - S Shahrir
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - K M Akgun
- Department of Internal Medicine, Veterans Affairs (VA) Connecticut Healthcare System and Yale University School of Medicine, New Haven, CT, USA
| | - C Wongtrakool
- Atlanta VA Medical Center and Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - S T Brown
- Department of Medicine, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - J W Kim
- Department of Medicine, James J. Peters VA Medical Center, Bronx, NY, USA
| | - G W Soo Hoo
- VA Greater Los Angeles Healthcare System and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - M C Rodriguez-Barradas
- Michael E. DeBakey VA Medical Center and Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - L Huang
- Center for AIDS Research, University of California at San Francisco, San Francisco, CA, USA
| | - L C Feemster
- VA Puget Sound Healthcare System, University of Washington, Seattle, WA, USA
| | - J Zifodya
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - K Crothers
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.,VA Puget Sound Healthcare System, University of Washington, Seattle, WA, USA
| |
Collapse
|
48
|
Ngueta G. Lifetime Average Cannabis Use in Relation to Hypertriglyceridemic Waist Phenotype in U.S. Adults: A Population-Based Cross-Sectional Study. Cannabis Cannabinoid Res 2020; 5:246-254. [PMID: 32923661 DOI: 10.1089/can.2019.0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background and Aims: With a growing number of states legalizing recreational or medical cannabis, prevalence of cannabis users is expected to markedly increase in the future. We aim to determine the association between lifetime cannabis use and the likelihood for hypertriglyceridemic waist (HTGW+/+) phenotype in U.S. adults. Methods: We abstracted data from the National Health and Nutrition Examination Survey from 2009 to 2016. We estimated the minimal lifetime cannabis use using the duration of regular exposure and the frequency of use. Outcomes were HTGW+/+ phenotype, defined as being waist circumference >90 cm (for men) or 85 cm (for women), and serum fasting triglycerides ≥177 mg/dL. We used multiple logistic regression models to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CIs). Results: Of the 47,364 adults included, 48.5% were women. The prevalence of HTGW+/+ phenotype was 11.7%. Current, but not former, users were less likely to show HTGW+/+ phenotype. Current cannabis users with greater or equal to four uses per week showed a significant lower likelihood for HTGW+/+ than those who never used cannabis (AOR 0.46 [95% CI, 0.22-0.97]). HTGW+/+ phenotype was associated with neither two to three uses per week (AOR 1.12 [95% CI, 0.40-3.12]) nor less than two uses per week (AOR 0.56 [95% CI, 0.18-1.73]). Conclusions: Average lifetime frequency of greater or equal to four cannabis uses per week is linked to lower odds of HTGW+/+ in current users. Former use is not associated with HTGW+/+.
Collapse
Affiliation(s)
- Gerard Ngueta
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL-UL), Quebec (Quebec), Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec (Quebec), Canada
| |
Collapse
|
49
|
Underner M, Peiffer G, Perriot J, Jaafari N. [Asthma and cannabis, cocaine or heroin use]. Rev Mal Respir 2020; 37:572-589. [PMID: 32653338 PMCID: PMC7345369 DOI: 10.1016/j.rmr.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/09/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The use of cannabis, cocaine or heroin can be responsible for many respiratory complications including asthma. OBJECTIVES The aim of this systematic literature review of data was to expose the relations between cannabis, cocaine or heroin use and asthma. RESULTS Cannabis, cocaine or heroin use by inhalation may be responsible for respiratory symptoms (cough, wheezing), asthma onset, acute asthma exacerbations (which may require intubation and invasive ventilation) or deaths related to asthma. Lower adherence to asthma treatment is also observed. Cannabis induces a rapid bronchodilator effect. In contrast, its chronic use may induce a decrease in specific airway conductance. Studies on forced expiratory volume in one second (FEV1) reduction or decline are discordant. CONCLUSION Cannabis, cocaine or heroin use must be considered in cases of acute respiratory symptoms or asthma exacerbation in young persons and practitioners must help illicit substance users to stop their consumption.
Collapse
Affiliation(s)
- M Underner
- Consultation de tabacologie, unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - J Perriot
- Dispensaire Émile-Roux, CLAT 63, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Consultation de tabacologie, unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
| |
Collapse
|
50
|
Abramson MJ, Murambadoro T, Alif SM, Benke GP, Dharmage SC, Glaspole I, Hopkins P, Hoy RF, Klebe S, Moodley Y, Rawson S, Reynolds PN, Wolfe R, Corte TJ, Walters EH. Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case-control study. Thorax 2020; 75:864-869. [PMID: 32660982 DOI: 10.1136/thoraxjnl-2019-214478] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/08/2020] [Accepted: 06/10/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown cause characterised by progressive scarring, with limited effective treatment and a median survival of only 2-3 years. Our aim was to identify potential occupational and environmental exposures associated with IPF in Australia. METHODS Cases were recruited by the Australian IPF registry. Population-based controls were recruited by random digit dialling, frequency matched on age, sex and state. Participants completed a questionnaire on demographics, smoking, family history, environmental and occupational exposures. Occupational exposure assessment was undertaken with the Finnish Job Exposure Matrix and Australian asbestos JEM. Multivariable logistic regression was used to describe associations with IPF as ORs and 95% CIs, adjusted for age, sex, state and smoking. RESULTS We recruited 503 cases (mean±SD age 71±9 years, 69% male) and 902 controls (71±8 years, 69% male). Ever smoking tobacco was associated with increased risk of IPF: OR 2.20 (95% CI 1.74 to 2.79), but ever using marijuana with reduced risk after adjusting for tobacco: 0.51 (0.33 to 0.78). A family history of pulmonary fibrosis was associated with 12.6-fold (6.52 to 24.2) increased risk of IPF. Occupational exposures to secondhand smoke (OR 2.1; 1.2 to 3.7), respirable dust (OR 1.38; 1.04 to 1.82) and asbestos (OR 1.57; 1.15 to 2.15) were independently associated with increased risk of IPF. However occupational exposures to other specific organic, mineral or metal dusts were not associated with IPF. CONCLUSION The burden of IPF could be reduced by intensified tobacco control, occupational dust control measures and elimination of asbestos at work.
Collapse
Affiliation(s)
- Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tsitsi Murambadoro
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheikh M Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Geza P Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ian Glaspole
- Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Peter Hopkins
- School of Medicine, University of Queensland, St Lucia, Queensland, Australia.,Lung Transplant Service, Prince Charles Hospital, Chermside, Queensland, Australia
| | - Ryan F Hoy
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Yuben Moodley
- School of Pharmacology and Respiratory Medicine, Lung Institute of Western Australia, University of Western Australia, Perth, Western Australia, Australia.,Department of Respiratory and Sleep Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Shuli Rawson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paul N Reynolds
- Department of Respiratory Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tamera J Corte
- Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - E Haydn Walters
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | | |
Collapse
|