Child Maltreatment History, Deployment-Related Traumatic Events, and Past 12-Month Cannabis Use Among Veterans in Canada

OBJECTIVE

Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans.

METHOD

Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only n = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use.

RESULTS

The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, - 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found.

CONCLUSIONS

Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans.

Trends in Illicit Cannabis Potency based on the Analysis of Law Enforcement Seizures in the Southern Area of Rome

Cannabis remains the most illicitly produced and consumed substance worldwide, and the average trans-Δ9-tetrahydrocannabinol (THC) content in cannabis products (marijuana, hashish) has increased over time. This paper presents data about THC concentration in cannabis resin samples seized by law enforcement from 2015 to 2022 in the southern area of Rome (Italy). From 2015 to 2022, more than 1000 hashish samples were analyzed; the average THC content was 18.0% and dramatically increased from 13.7% (2015) to 27.1% (2022). The potency of THC in some samples characterized by unusual shape and color was higher than 24% and, in a few cases, higher than 40%. The age group most involved in seizures of cannabis resin concerned males aged between 15 and 36 years old. The spread of this phenomenon increases the risk of adverse health outcomes. Many observational studies compare the increased cannabis potency with the onset of psychosis, depression, anxiety and cannabis use disorders (CUDs), mainly in young adults. THC-potency monitoring provides data that can be helpful to create a network of communication and interaction between universities, and legislative and public health institutions to support education, awareness and surveillance related to cannabis abuse.

Novel Solventless Extraction Technique to Preserve Cannabinoid and Terpenoid Profiles of Fresh Cannabis Inflorescence

Despite its use by humans for thousands of years, the technology of cannabis usage and extraction is still evolving. Given that the primary pharmacological compounds of interest are cannabinoid and terpenoids found in greatest abundance in capitate glandular trichomes of unfertilized female inflorescences, it is surprising that older techniques of hashish making have received less technological advancement. The purpose of this study was to employ organically grown cannabis and to isolate pure trichomes from freshly picked flowers via exposure to vapor from solid CO₂, commonly known as “dry ice”, followed by their isolation via sifting through a 150 µ screens while maintaining the cold chain. Biochemical analysis was undertaken on fresh flower, frozen-sifted flower by-products, treated trichomes (Kryo-Kief™), dried flower, dried sifted flower by-product and dried kief. The dry ice process successfully concentrated cannabinoid content as high as 60.7%, with corresponding concentration and preservation of monoterpenoids encountered in fresh flower that are usually lost during the conventional cannabis drying and curing process. The resulting dried sifted flower by-product after dry ice processing remains a usable commodity. This approach may be of interest to pharmaceutical companies and supplement producers pursuing cannabis-based medicine development with an eye toward full synergy of ingredients harnessing the entourage effect.

Δ9-Tetrahydrocannabinolic acid A, the precursor to Δ9-tetrahydrocannabinol (THC)

While Δ⁹-tetrahydrocannabinolic acid A (THCA-A) has been reported to be difficult to crystallize and/or amorphous, we have obtained THCA-A in a pure crystalline form by extraction of marijuana and selective fractionation with liquid CO₂. THCA-A (systematic name: 1-hydroxy-6,6,9-trimethyl-3-pentyl-6a,7,8,10a-tetrahydro-6H-benzo[c]isochromene-2-carboxylic acid, C₂₂H₃₀O₄) crystallizes in the orthorhombic space group P2₁2₁2₁, with Z = 8 and Z' = 2. The two independent molecules are related by a pseudo-twofold axis centered between the two -CO₂H groups, but the conformations of the two -C₅H₁₁ chains are quite different (tgt and ttg; t is trans and g is gauche). The carboxylate groups form an intermolecular R₂²(8) hydrogen-bonded ring; the two C₂O₂ carboxylate planes are twisted out of the planes of the attached arene rings in opposite directions by 13.59 (8) and 18.92 (8)°, respectively, with a resultant interplanar angle of 28.89 (8)°. Each molecule also has an intramolecular S(6) hydrogen-bond motif between the ortho -OH group and the dihydropyran-ring O atom. Other conformational aspects of the two independent molecules are quite similar to those found in the previously determined structure of THCA-B. THCA-A has shown promise in a number of medical applications. Demonstration of the crystallinity and details of the crystal structure are expected to provide a standard point of departure for chemical and medical experiments.

Characterising heterogeneity in the use of different cannabis products: latent class analysis with 55 000 people who use cannabis and associations with severity of cannabis dependence

BACKGROUND

As new cannabis products and administration methods proliferate, patterns of use are becoming increasingly heterogeneous. However, few studies have explored different profiles of cannabis use and their association with problematic use.

METHODS

Latent class analysis (LCA) was used to identify subgroups of past-year cannabis users endorsing distinct patterns of use from a large international sample (n = 55 240). Past-12-months use of six different cannabis types (sinsemilla, herbal, hashish, concentrates, kief, edibles) were used as latent class indicators. Participants also reported the frequency and amount of cannabis used, whether they had ever received a mental health disorder diagnosis and their cannabis dependence severity via the Severity of Dependence Scale (SDS).

RESULTS

LCA identified seven distinct classes of cannabis use, characterised by high probabilities of using: sinsemilla & herbal (30.3% of the sample); sinsemilla, herbal & hashish (20.4%); herbal (18.4%); hashish & herbal (18.8%); all types (5.7%); edibles & herbal (4.6%) and concentrates & sinsemilla (1.7%). Relative to the herbal class, classes characterised by sinsemilla and/or hashish use had increased dependence severity. By contrast, the classes characterised by concentrates use did not show strong associations with cannabis dependence but reported greater rates of ever receiving a mental health disorder diagnosis.

CONCLUSIONS

The identification of these distinct classes underscores heterogeneity among cannabis use behaviours and provides novel insight into their different associations with addiction and mental health.

History of cannabis and the endocannabinoid system

This article retraces the story of cannabis from the earliest contacts of humans with the plant to its subsequent global expansion, its medicinal uses, and the discovery of the endocannabinoid system in the 20^th century. Cannabis was attested to around 12 000 years ago near the Altai Mountains in Central Asia, and since then, cannabis seeds have accompanied the migration of nomadic peoples. Records of the medicinal use of cannabis appear before the Common Era in China, Egypt, and Greece (Herodotus), and later in the Roman empire (Pliny the Elder, Dioscorides, Galen). In the 19^th century, orientalists like Silvestre de Sacy, and Western physicians coming into contact with Muslim and Indian cultures, like O’Shaughnessy and Moreau de Tours, introduced the medicinal use of cannabis into Europe. The structure of the main psychoactive phytocannabinoid, tetrahydrocannabinol (THC), was determined in Israel by Mechoulam and Gaoni in 1964. This discovery opened the gate for many of the subsequent developments in the field of endocannabinoid system (ECS) research. The advances in the scientific knowledge of the ECS place the debate on cannabis liberalization in a new context.


Pediatric cannabis poisonings in France: more and more frequent and severe

CONTEXT

Accidental pediatric cannabis poisonings are an incidental effect of cannabis use. The average THC content of cannabis resin and the number of consumers are rising sharply in the USA and in most European countries. The objective is to study the evolution of prevalence and severity of pediatric exposures to cannabis in France.

METHOD

This is a retrospective observational study of cases detected by French poison centers between January 1^st 2010 and December 31^st 2017 of cannabis exposure by ingestion in children aged ten or younger. The clinical severity was assessed using the Poisoning Severity Score (PSS). The criteria used for assessing the overall severity were as follows: PSS ≥ 2, admission to pediatric intensive care, coma and respiratory depression (univariate and multivariate logistic regression).

RESULTS

A total of 965 cases of poisoning were covered. The annual average number of cases was 93 between 2010 and 2014 and 167 between 2015 and 2017. The median age was 15 months (range, 6 months-10 years) and the sex ratio was 1:1. The form of cannabis ingested was mainly resin (75%). During the period covered by the study, 26.1% of children (n = 252) presented with a PSS ≥ 2, 4.5% (n = 43) coma, 4.6% (n = 44) with respiratory depression and 11.7% (n = 113) were admitted into pediatric intensive care (out of 819 hospitalizations). No fatal cases were reported. In comparison to the 2010-2014 period, the length of hospital stays was significantly higher (p < 0.0001) and the comas were significantly deeper (lower score on the Glasgow coma scale, p < 0.005) in 2015-2017. Following adjustments made for the sex, age and weight of the children, the data show that the severity of the poisonings was significantly greater in 2015-2017 in terms of PSS score, the number of comas and monitoring in intensive care (p < 0.001).

CONCLUSION

The data indicates a significant increase in the number of cases of pediatric exposure to cannabis and a rise in the seriousness of poisonings between 2010 and 2017.

Cannabis-like activity of Zornia latifolia Sm. detected in vitro on rat cortical neurons: major role of the flavone syzalterin

Zornia latifolia is a plant suspected to possess psychoactive properties and marketed as a marijuana substitute under the name 'maconha brava'. In this study, the effects of fractions obtained from a 2-propanol extract of aerial portions of the plant were determined by multielectrode array (MEA) analyses on cultured networks of rat cortical neurons. Lipophilic (ZL_lipo, mainly containing flavonoid aglycones), and hydrophilic (ZL_hydro, mainly containing flavonoid glycosides) fractions were initially obtained from the raw extract. ZL_lipo significantly inhibited mean firing rate (MFR) and mean bursting rate (MBR) of MEA recordings, while ZL_hydro induced no inhibition. Column chromatography separation of ZL_lipo yielded five fractions (ZL1-ZL5), among which ZL1 induced the strongest MFR and MBR inhibition. NMR and HPLC-MS analyses of ZL1 revealed the prevalence of the common flavonoids genistein (1) and apigenin (2) (in about a 1:1 ratio), and the presence of the rare flavone syzalterin (6,8-dimethylapigenin) (3) as a minor compound. Exposures of MEA to apigenin and genistein standards did not induce the MFR and MBR inhibition observed with ZL1, whereas exposure to syzalterin standard or to a 1:9 mixture syzalterin-genistein induced effects similar to ZL1. These inhibitory effects were comparable to that observed with high-THC hashish, possibly accounting for the plant psychoactive properties. Data indicate that Z. latifolia, currently marketed as a free herbal product, should be subjected to measures of control. In addition, syzalterin showed distinctive pharmacological properties, opening the way to its possible exploitation as a neuroactive drug.

Electronic Cigarettes to Vaporize Cannabis: Prevalence of Use and Associated Factors among Current Electronic Cigarette Users in Germany (DEBRA Study)

Background: In Germany, cannabis is the most widely used illicit drug, and inhalation together with tobacco is most popular. However, it has been described that electronic cigarettes (ECs) are being used to vaporize cannabis (extract). No current data on EC cannabis use in the German population are yet available. Objectives: This study examines the prevalence of EC cannabis consumption for mood changing effects among current EC users, and associated consumer characteristics in Germany. Methods: We used data from the German Study on Tobacco Use (period: 8/2016-01/2019, DEBRA, www.debra-study.info), a nationally representative household survey. EC cannabis use for mood-changing effects was assessed in 504 current EC users (aged ≥ 18 years) of the total sample (N = 32,678). Ever use was defined by: (1) occasional or regular use, or (2) experimental consumption. Associations with socio-demographic consumer characteristics and tobacco smoking were analyzed using multivariable regression analyses. Results: Amongst current EC users, 7.2% had ever vaporized cannabis: 2.3% (95%CI = 1.2-3.9) reported occasional or regular use (1) and 4.8% (95%CI = 3.2-7.1) reported experimental use (2). Age was associated with ever EC cannabis use: highest prevalence rates were found among 18-24-year-olds: 6.5% (95%CI = 2.3-13.1) (1) and 8.0% (95%CI = 3.7-15.8) (2), respectively. The majority (90.2%) of ever EC cannabis users were current tobacco smokers. Conclusions: One in 14 current EC users in Germany has ever vaporized cannabis for mood-changing reasons, and almost all EC cannabis consumers also smoke tobacco. Highest usage rates can be observed among young adults. Hence, trends of EC drug misuse need to be monitored consequently, particularly in young people.

A reciprocal effects analysis of cannabis use and perceptions of risk

BACKGROUND AND AIMS

Adolescents and young adults increasingly view cannabis as a relatively safe drug. Perception of risk associated with cannabis use is correlated negatively with the prevalence of use, but the causal nature of this association is debated. The aim of this study is to quantitate the reciprocal associations between cannabis use and risk perception in a longitudinal panel of emerging adults.

DESIGN

Observational study of longitudinal data from the Monitoring the Future longitudinal study using autoregressive cross-lagged panel analyses to investigate reciprocal associations between cannabis risk perception and frequency of past-year cannabis use.

SETTING

Surveys administered to 12th-grade students from the United States general population.

PARTICIPANTS

A total of 9929 12th-grade students (mean age 18.0 years) who were surveyed initially during 2000-05 and follow-up data until approximately 23-24 years old (three waves; n = 9929).

MEASUREMENTS

Perception of risk association with cannabis use and frequency of past-year cannabis use.

RESULTS

At baseline, 33% of the 12th-graders used cannabis in the past year versus 28% by the third follow-up; 83% believed that smoking cannabis regularly carried moderate or great risk versus 78% by the third follow-up. All cross-lagged paths in both directions were statistically significant (all P < 0.001), consistent with reciprocal influences between cannabis use and risk perception. The negative association between past-year cannabis use and subsequent risk perception (standardized coefficient range -0.21 to -0.27) was stronger than that between risk perception and subsequent use (standardized coefficient range -0.08 to -0.11; confidence intervals did not overlap with those for the coefficients reported above). Similar results were obtained when the analysis was limited to those who had never used cannabis prior to baseline.

CONCLUSIONS

Longitudinal associations between cannabis use and perception of risks from cannabis use are reciprocal in nature, with a stronger association between cannabis use and lower subsequent risk perception.

Assessment of oxidative stress of platelets among chronic heroin and hashish addicts

INTRODUCTION

Illicit drugs abuse is associated with several clinical life-threatening consequences that are primarily mediated by oxidative damage to multiple cellular components with a subsequent cellular dysfunction and death. Primarily, this study aimed to investigate oxidative stress to protein and lipid components of circulatory platelets among chronic heroin and hashish addicts.

METHODS

Platelet lysates were prepared from 20 chronic intravenously administrated heroin addicts and 20 chronic smoked hashish addicts. For comparative purposes, two control groups of 20 cigarette smokers and 20 nonsmokers were included in the study. Oxidative stress to platelet's proteins and lipids was investigated using carbonyl group contents assay and thiobarbituric acid reactive substances (TBARS) assay, respectively.

RESULTS

In comparison to control groups, carbonyl group contents and TBARS concentration were significantly higher among heroin addicts but not among hashish addicts. Both of these markers were significantly correlated to the duration of addiction but not to the daily administrated dose. While in regard of the timing of the latest administrated dose (TLAD), only carbonyl group contents were significantly correlated to the TLAD.

CONCLUSIONS

Considering the contribution of drug's route of administration, drug's pharmacokinetics, and kinetics of circulatory platelet, we concluded that chronic heroin addiction is associated with significant levels of oxidative stress to platelet's proteins and lipids. Due to the high proteomic contents of platelets, protein's oxidative stress is more prominent compared to lipids. Chronic hashish smoking is not associated with significant levels of oxidative stress in platelet's proteins and lipids.

Recurrent cannabis use among Norwegian students: Prevalence, characteristics, and polysubstance use

Background:

Research on cannabis has focused on lifetime use or regular/heavy use (i.e., daily or almost daily). Regular, albeit not necessarily daily, cannabis use has received less scientific attention.

Objectives:

This study aims to identify demographic and personality factors associated with recurrent cannabis use (i.e., cannabis usage 5 to 50 times in the last six months) and to investigate the relationship between cannabis use and use of other substances.

Methods:

Public and private university students (N = 11,236) in Bergen, Norway, participated in an online survey during autumn 2015. Binary logistic regression was run to identify individual characteristics related to recurrent cannabis use. Chi-square tests were conducted to investigate differences in substance use (alcohol, nicotine, and illicit drugs) between recurrent cannabis users and cannabis abstainers/low-frequency users.

Results:

A total of 4.0% of the students reported recurrent cannabis use. Students born in North America, non-Christians (compared to non-religious students), and men were more likely to be recurrent users. Recurrent cannabis users scored higher on extroversion and intellect/imagination compared to abstainers/low-frequency users. Male and female recurrent cannabis users had somewhat different characteristics (e.g., agreeableness scores were negatively associated with recurrent use among females but not among males). Recurrent cannabis use was overall strongly associated with polysubstance use.

Conclusions:

The prevalence of recurrent cannabis use among Norwegian students is low. Recurrent cannabis use seems more prevalent among individuals marked by extroversion and intellect/imagination, which supports the notion of cannabis use as a social activity for individuals identifying themselves as outgoing and unconventional. Cannabis use among students seems strongly associated with use of other substances, suggesting that cannabis should not be considered a replacement drug.

Exposure to Psychoactive Compounds amongst Students of Medical University

OBJECTIVE

The aim of this study was to assess the frequency of exposure to psychoactive compounds amongst students of the Medical University of Bialystok.

METHOD

This cross-sectional study included 504 students selected by means of stratified sampling based on the university faculty, study discipline and year, and participant's gender.

RESULTS

Nearly three fourths of our respondents have contact with their student colleagues who use psychoactive compounds, or have heard that such individuals exist. Approximately one fourth of the students declared that they considered using psychoactive compounds at least once. Marijuana and hashish were the psychoactive compounds our respondents used most frequently. Median age of the first contact with these substances was 18 years. Alarmingly high fraction of respondents declared that most of psychoactive compounds included in the study is easily available and obtaining them would not take them longer than one day. Furthermore, 15% of respondents admitted to being involved in the distribution of psychoactive compounds.

CONCLUSION

The exposure of medical university students to psychoactive compounds represents similar problem as in their peers studying other disciplines. However, in view of its specific consequences (including potential threat to patients' health and life), the problem should not be underestimated.

Potency trends of Δ9-tetrahydrocannabinol, cannabidiol and cannabinol in cannabis in the Netherlands: 2005-15

BACKGROUND AND AIMS

Between 2000 and 2005 the average percentage of Δ(9) -tetrahydrocannabinol (THC) in marijuana as sold in Dutch coffeeshops has increased substantially; the potency of domestic products (Nederwiet and Nederhasj) has particularly increased. In contrast with imported marijuana, Nederwiet hardly contained any cannabidiol (CBD), a cannabinoid that is thought to offset some of the adverse effects of THC. In 2005, the THC content in Nederwiet was significantly lower than in 2004. This study investigates the further decrease or increase of cannabinoids in these cannabis products.

METHODS

From 2005 to 2015 five different cannabis products were bought anonymously in 50 coffeeshops that were selected randomly each year from all coffeeshops in the Netherlands. A total of 2126 cannabis samples were bought, consisting of 664 Nederwiet samples (most popular), 537 Nederwiet samples (supposed strongest varieties), 183 imported herbal cannabis samples, 140 samples of cannabis resin made of Nederwiet and 602 samples of imported cannabis resin. All samples were analysed chemically for their THC, CBD and cannabinol (CBN) content.

RESULTS

Between 2005 and 2015, the mean potencies of the most popular and the strongest Nederwiet and of imported cannabis resin were 16.0±4.0%, 17.0±3,9% and 16.5±6.3%, respectively. Imported herbal cannabis (6.5±3.5%) and cannabis resin made from Nederwiet (30.2±16.4%) contained, respectively, less (β=-10.0, P<0.001) and more (β=13.7, P<0.001) THC than imported cannabis resin. Linear regression models were used to study the trends in THC of the different cannabis products over time. A marginal, but significant (P<0.001), overall decline of THC per year of 0.22% was found in all cannabis products. However, no significant difference was found between the five products in the THC linear trajectories across time. Of all the cannabis products, only imported cannabis resin contained a relatively high CBD/THC ratio (median 0.42).

CONCLUSION

The average tetrahydrocannabinol (THC) content of the most popular herbal cannabis products in the Netherlands has decreased slightly since 2005. The popular Nederwiet type still has a relatively high THC to cannabidiol ratio.

Prevalence and correlates of hashish use in a national sample of high school seniors in the United States

BACKGROUND

Cannabis (marijuana) use and acceptance towards use are increasing in the US, and state-level policies are becoming more liberal. A wealth of research has been conducted to examine risk factors for use; however, studies rarely differentiate between different forms of marijuana.

OBJECTIVE

We sought to determine prevalence of use and delineate who is at risk for use of hashish, a more potent form of marijuana.

METHODS

We examined data from a nationally representative sample of high school seniors in the Monitoring the Future study (2007-2011; weighted n = 10 597). We determined how sociodemographic factors and reasons for marijuana use correlated with recent (12 month) hashish use.

RESULTS

Prevalence of recent hashish use was 6.5% and it was used by 18.3% of recent marijuana users. Hashish and other marijuana use tended to share many of the same correlates; however, associations were often stronger for hashish use. Females were consistently at low risk for use and users of other drugs were consistently at high risk for use. Black students tended to be at low risk for hashish use. Low risk of identifying as Hispanic or religious and high risk of higher personal income or going out more evenings per week for fun disappeared when controlling for other drug use. Using marijuana because the student felt he/she was "hooked" nearly doubled the odds for hashish use.

CONCLUSIONS

This was the first national study to examine prevalence and correlates of hashish use. These findings can inform prevention in a time of increasing popularity of marijuana use.