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Okpujie V, Ozumba S, Olaomi OA, Uwumiro FE, Ajiboye AE, Abesin O, Solomon RO, Ogunfuwa OM, Hassan JH, Opeyemi MR. Green Smoke, Red Flag: Cannabis and the Risk of Orbitopathy and Dermopathy in Thyrotoxicosis. Cureus 2023; 15:e39092. [PMID: 37378109 PMCID: PMC10291966 DOI: 10.7759/cureus.39092] [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: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Background The use of cannabis has been associated with an array of multi-systemic physiological effects. However, the medical literature on the potential role of cannabinoids in the management and outcomes of thyrotoxicosis remains scarce. We studied the association between cannabis use and orbitopathy, dermopathy, and the length of hospital stay for thyrotoxicosis admissions. Methods A thorough analysis was conducted on adult hospitalizations in 2020 with a primary discharge diagnosis of thyrotoxicosis, using data from the Nationwide Inpatient Sample (NIS). To ensure data completeness and consistency, hospitalizations with missing or incomplete information, as well as those involving patients under 18 years of age, were excluded from the study. The remaining study sample was categorized into two groups based on the presence or absence of cannabis use, as determined by ICD-10-CM/PCS codes. Subtypes of orbitopathy, dermopathy, and potential confounding factors were identified based on previous literature and defined using validated ICD-10-CM/PCS codes. The association between cannabis use and the outcomes was evaluated using multivariate regression analysis. The primary focus was on thyroid orbitopathy, while dermopathy and the average length of hospital stay were considered as secondary outcomes. Results A total of 7,210 hospitalizations for thyrotoxicosis were included in the analysis. Among them, 404 (5.6%) were associated with cannabis use, while 6,806 (94.4%) were non-users serving as controls. Cannabis users were predominantly female (227, 56.3%), which was similar to the control group (5,263, 73%), and they were primarily of Black descent. Notably, the cohort of cannabis users was significantly younger than the control group (37.7 ± 1.3 vs. 63.6 ± 0.3). Upon conducting multivariate regression analysis, it was found that cannabis use was linked to a significant increase in the odds of orbitopathy among patients with thyrotoxicosis (AOR: 2.36; 95% CI: 1.12-4.94; P = 0.02). Additionally, a history of tobacco smoking was also correlated with higher odds of orbitopathy in the study (AOR: 1.21; 95% CI: 0.76-1.93; p = 0.04). However, no significant association was observed between cannabis use and the odds of dermopathy (AOR: 0.88; 95% CI: 0.51-1.54; p = 0.65) or the average length of hospital stay (IRR: 0.44; 95% CI: 0.58-1.46; p = 0.40). Conclusion The study identified a significant association between cannabis use and increased odds of orbitopathy in patients with thyrotoxicosis. Additionally, a history of tobacco smoking was also found to be correlated with augmented odds of orbitopathy.
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Affiliation(s)
| | - Sara Ozumba
- Family Medicine, University of Nigeria, Nsukka, NGA
| | | | - Fidelis E Uwumiro
- Surgery, Our Lady of Apostles Hospital, Akwanga, NGA
- Surgery, College of Medical Sciences, University of Jos, Jos, NGA
| | | | - Olawale Abesin
- Internal Medicine, Royal Cornwall Hospitals NHS Trust, Cornwall, GBR
| | - Rebecca O Solomon
- Paediatrics and Child Health, Community Medicine, Lagos State Primary Health Care, Ijora Primary Health Centre, Lagos, NGA
| | | | - Judith H Hassan
- Health Sciences and Social Work, Western Illinois University, Macomb, USA
| | - Mojeed R Opeyemi
- Internal Medicine, Federal Medical Centre Abeokuta, Abeokuta, NGA
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Karki P, Rangaswamy M. A Review of Historical Context and Current Research on Cannabis Use in India. Indian J Psychol Med 2023; 45:105-116. [PMID: 36925496 PMCID: PMC10011848 DOI: 10.1177/02537176221109272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The cultivation and use of cannabis is historically rooted in the Indian subcontinent and this rich heritage of cannabis use dates back to at least two thousand years. Cannabis remains an illicit substance in India despite its changing status globally with many countries legalizing cannabis use in recent years. Scientific research on cannabis use in India has also been sparse. Method Extensive search of online databases resulted in the identification of 29 original research studies pertaining to one of three areas of cannabis research; a) prevalence of cannabis use b) psychological correlates of cannabis use, c) cannabis use in substance use treatment settings. Findings We found that most Indian studies used very basic quantitative research designs and had poor scientific rigor. Samples were small, region specific and included only males. Data analyses were limited to descriptive methods. The criteria for cannabis use in most of the reviewed studies were not rigorous and prone to biases. Conclusion & Implications With changing attitudes and loosening of restrictions on cannabis use, the prevalence of new users is rising dramatically particularly in the college going population. This presents a strong need for research on motivations and attitudes to cannabis use and how those can influence patterns of use, and also the short- and long-term effects of use. More studies with stronger research designs (both cross sectional and longitudinal) are required for the study of cannabis use and this knowledge will be critical for managing the growing substance epidemic, generating public health solutions as well as formulating effective policy frameworks.
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Affiliation(s)
- Prakat Karki
- Dept. of Psychology, CHRIST (Deemed to be University), Bangalore, Karnataka, India
| | - Madhavi Rangaswamy
- Dept. of Psychology, CHRIST (Deemed to be University), Bangalore, Karnataka, India
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Mannekote Thippaiah S, Iyengar SS, Vinod KY. Exo- and Endo-cannabinoids in Depressive and Suicidal Behaviors. Front Psychiatry 2021; 12:636228. [PMID: 33967855 PMCID: PMC8102729 DOI: 10.3389/fpsyt.2021.636228] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
Cannabis (marijuana) has been known to humans for thousands of years but its neurophysiological effects were sparsely understood until recently. Preclinical and clinical studies in the past two decades have indisputably supported the clinical proposition that the endocannabinoid system plays an important role in the etiopathogeneses of many neuropsychiatric disorders, including mood and addictive disorders. In this review, we discuss the existing knowledge of exo- and endo-cannabinoids, and role of the endocannabinoid system in depressive and suicidal behavior. A dysfunction in this system, located in brain regions such as prefrontal cortex and limbic structures is implicated in mood regulation, impulsivity and decision-making, may increase the risk of negative mood and cognition as well as suicidality. The literature discussed here also suggests that the endocannabinoid system may be a viable target for treatments of these neuropsychiatric conditions.
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Affiliation(s)
- Srinagesh Mannekote Thippaiah
- Valleywise Behavioral Health, Phoenix, AZ, United States.,Creighton University School of Medicine, Phoenix, AZ, United States
| | - Sloka S Iyengar
- The American Museum of Natural History, New York, NY, United States
| | - K Yaragudri Vinod
- Department of Analytical Psychopharmacology, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Department of Child & Adolescent Psychiatry, New York University Langone Health, New York, NY, United States
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Poleg S, Golubchik P, Offen D, Weizman A. Cannabidiol as a suggested candidate for treatment of autism spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:90-96. [PMID: 30171992 DOI: 10.1016/j.pnpbp.2018.08.030] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 12/26/2022]
Abstract
Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication, restricted and repetitive patterns of behavior, interests, or activities and often intellectual disabilities. ASD has a number of prevalent co-morbidities, such as sleep disorders, attention deficit/hyperactivity disorder and epilepsy. No effective treatment for the core symptoms of ASD is currently available. There is increasing interest in cannabinoids, especially cannabidiol (CBD), as monotherapy or add-on treatment for the core symptoms and co-morbidities of ASD. In this review we summarize the available pre-clinical and clinical data regarding the safety and effectiveness of medical cannabis, including CBD, in young ASD patients. Cannabidiol seems to be a candidate for the treatment of ASD. At present, however, there are no convincing pre-clinical or clinical data showing efficacy and safety of cannabinoid treatment in ASD patients.
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Affiliation(s)
- Shani Poleg
- Felsenstein Medical Research Center, Tel Aviv University, Petah - Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pavel Golubchik
- Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah -Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Offen
- Felsenstein Medical Research Center, Tel Aviv University, Petah - Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Felsenstein Medical Research Center, Tel Aviv University, Petah - Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Research Unit, Geha Mental Health Center, Petah - Tikva, Israel.
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Erratum: Cannabis: Does it have a medicinal value? Indian J Psychiatry 2017; 59:528. [PMID: 29498378 PMCID: PMC5806347 DOI: 10.4103/0019-5545.223488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
[This corrects the article on p. 262 in vol. 59, PMID: 29085083.].
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