cannabidiol and Marijuana-Use

Cannabis is a naturally occurring plant that is composed of over sixty phytocannabinoids, of which cannabidiol (CBD) has been recently identified as having therapeutic potential.. Although not clearly understood in its mechanism of action, CBD contains potent anti-inflammatory, anti-hyperalgesia, and analgesic qualities now being further analyzed for its use in the treatment of a plethora of diseases. Related to its large safety profile and lack of psychoactive effects typically associated with cannabis and tetrahydrocannabinol (THC), CBD is being used more frequently for self-treatment of chronic pain, anxiety, and depression. With the help of broad marketing, CBD is being used by numerous people, including pregnant women who use CBD as an anti-emetic. Since marijuana is legalized in many states in the USA, the use of CBD has increased not only in the general population but also in specific groups such as pregnant women with chronic pain. Despite CBD's accessibility, there are limited studies showing its safety during pregnancy. While the use of cannabis has been well explored in terms of the effects on pregnancy, the use of CBD during pregnancy thus far has limited literature. The goal of this investigation is to impart the current understanding of CBD and its effects of pregnancy.

Topics: Animals; Anxiety; Cannabidiol; Congenital Abnormalities; Female; Humans; Marijuana Use; Morning Sickness; Pain; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects

Cannabinoids, the psychoactive compounds in marijuana, are one of the most commonly used substances in the United States. In this review, we summarize the impact of marijuana on child and adolescent health and discuss the implications of marijuana use for pediatric practice. We review the changing epidemiology of cannabis use and provide an update on medical use, routes of administration, synthetic marijuana and other novel products, the effect of cannabis on the developing brain, other health and social consequences of use, and issues related to marijuana legalization.

Topics: Adolescent; Adolescent Behavior; Animals; Brain; Cannabidiol; Cannabinoids; Cannabis; Child; Child Behavior; Drug Interactions; Endocannabinoids; Female; Fetus; Humans; Illicit Drugs; Male; Marijuana Abuse; Marijuana Use; Mass Media; Medical Marijuana; Milk, Human; Neurocognitive Disorders; Pregnancy; Prenatal Exposure Delayed Effects; Receptors, Cannabinoid; Tobacco Use

Cannabidiol (CBD) is an alkaloid present in

Topics: Animals; Cannabidiol; Cannabinoids; Cannabis; Dronabinol; Drug Approval; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana

Cannabis is the most prevalent illicit drug used by adolescents worldwide. Over the past 40 years, changes in cannabis potency through rising concentrations of Δ-9-tetrahydrocannabiol (THC), decreases in cannabidiol, or both, have occurred. Epidemiological and experimental evidence demonstrates that cannabis with high THC concentrations and negligible cannabidiol concentrations is associated with an increased risk of psychotic outcomes, an effect on spatial working memory and prose recall, and increased reports of the severity of cannabis dependence. However, many studies have failed to address cannabis use in adolescence, the peak age at which individuals typically try cannabis and probably the most vulnerable age to experience its harmful effects. In this Review, we highlight the influence that changing cannabis products have on adolescent health and the implications they carry for policy and prevention measures as legal cannabis markets continue to emerge worldwide.

Topics: Adolescent; Adolescent Health; Cannabidiol; Cannabis; Humans; Marijuana Use

In the United States, federal and state laws regarding the medical use of cannabis and cannabinoids are in conflict and have led to confusion among patients, caregivers, and healthcare providers. Currently, cannabis is legal for medical purposes in 50% of the states, and another seventeen states allow products that are high in cannabidiol (CBD) and low in THC (tetrahydrocannabinol) for medical use. Many of these artisanal products are sold in dispensaries or over the internet. However, none of these products has been approved by the Food and Drug Administration (FDA). Understanding how federal laws apply to clinical research and practice can be challenging, and the complexity of these laws has resulted in particular confusion regarding the legal status of CBD. This paper provides an up-to-date overview (as of August 2016) of the legal aspects of cannabis and cannabidiol, including cultivation, manufacture, distribution, and use for medical purposes. This article is part of a Special Issue title, Cannabinoids and Epilepsy.

Topics: Cannabidiol; Cannabinoids; Cannabis; Dronabinol; Epilepsy; Federal Government; Humans; Marijuana Use; Medical Marijuana; State Government; United States

Knowledge about exposure to cannabidiol (CBD) in breastfed infants can provide an improved understanding of potential risk. The aim was to predict CBD exposure in breastfed infants from mothers taking CBD and CBD-containing products.. Cannabidiol concentrations in milk previously attained from data collected through an existing human milk research biorepository were used to simulate infant doses and identify subgroups. A developed pediatric physiologically based pharmacokinetic model produced virtual breastfed infants administered the simulated CBD doses. Predicted breastfed infant exposures and upper area under the curve ratios were compared to the lowest therapeutic dose for approved indications in children.. The existing human milk research biorepository contained 200 samples from 181 unique breastfeeding mothers for whom self-reported administration data and CBD concentrations had previously been measured. Samples that were above the lower limit of quantification with only one maternal administration type revealed that administration type, i.e., joint/blunt or edible versus oil or pipe, resulted in significantly different subgroups in terms of milk concentrations. Resulting simulated infant doses (ng/kg) were described by lognormal distributions with geometric means and geometric standard deviations: 0.61 ± 2.41 all concentrations, 0.10 ± 0.37 joint/blunt or edible, and 2.23 ± 8.15 oil or pipe. Doses administered to breastfed infants had exposures magnitudes lower than exposures in children aged 4-11 years administered the lowest therapeutic dose for approved indications, and low upper area under the curve ratios.. Based on real-world use, breastfeeding infants are predicted to receive very small exposures of CBD through milk. Studies examining adverse reactions will provide further insight into potential risk.

Topics: Breast Feeding; Cannabidiol; Child; Female; Humans; Infant; Marijuana Use; Milk, Human

Cannabis-derived products containing cannabidiol with no or minimal levels of delta 9-tetrahydrocannabinol (CBD products) are widely available in the United States and use of these products is common among young adults and those who use marijuana. The purpose of this study was to examine patterns and correlates of CBD product use and co-use with marijuana in a sample of young adults.. The study used cross-sectional survey data collected in 2019-2020 from a cohort of young adults (n = 2534; mean age 23) based primarily in California. The survey assessed lifetime, past-year, and past-month frequency and type of CBD products used, frequency and amount of marijuana consumption and indicators of marijuana use-related problems. Linear, Poisson, and logistic regression models compared individuals reporting past month CBD-only use, marijuana-only use, concurrent CBD + marijuana use (co-use), and use of neither product. Among those reporting co-use, we examined associations between CBD use frequency and marijuana use frequency and heaviness of use (occasions per day) and indicators of problem marijuana use (e.g., Cannabis Use Disorder Identification Test Short-Form, solitary use, marijuana consequences).. Approximately 13% of respondents endorsed past-month CBD use; of these, over three-quarters (79%) indicated past-month co-use of marijuana. Among individuals reporting co-use, more frequent CBD use was associated with more frequent and heavier marijuana use but was not associated with marijuana use-related problems.. CBD use was common and associated with higher levels of marijuana consumption in this sample. Routinely assessing CBD use may provide a more comprehensive understanding of individuals' cannabis product consumption.

Topics: Adult; Cannabidiol; Cannabis; Cross-Sectional Studies; Dronabinol; Humans; Marijuana Smoking; Marijuana Use; United States; Young Adult

Detecting marijuana use is a component of most urine drug screens targeting a single Δ. Following the synthesis of a primary CBD metabolite, a LC-MS/MS assay was developed measuring the urinary metabolites tetrahydrocannabinol, 11-nor-carboxy-Δ. Clear data clusters enabled metabolic cut-points assignments. Forty-three percent of samples contained CBD metabolites in ten-fold excess to tetrahydrocannabinol metabolites which was then used as a set point to classify donors as CBD users. An excess of tetrahydrocannabinol metabolites classify donors as marijuana users. Additionally, urine samples were procured from donors personally known to use commercial CBD. A method has been developed and utilized to distinguish marijuana use from tetrahydrocannabinol exposure from contaminated CBD use.

Topics: Cannabidiol; Dronabinol; Humans; Marijuana Use

Cannabidiol (CBD) is purportedly a promising therapeutic agent to provide relief for a variety of medical conditions with mild or no psychoactive effects. However, little is known about young adults who use cannabis and CBD-dominant products, and associations between CBD use and other drug use.. Young adults (aged 24-32) who currently used cannabis (n = 239) were surveyed in Los Angeles in March 2019 through March 2020. The sample was divided into CBD-dominant (at least 1:1 CBD:THC ratio) and THC-dominant product users. We described CBD forms, reasons and conditions for CBD use and examined between-group differences in sociodemographic characteristics, cannabis practices, health and other drug use.. CBD-dominant users were more likely to be female, use cannabis at lower frequency and amount (except for edible/drinkable/oral products), self-report medical motivation for cannabis use, use cannabis for pain and report more health problems. Oil, flower, topicals and sprays/drops/tinctures were the most prevalent CBD forms. Psychological problems and pain were commonly reported conditions and medical reasons for CBD use. CBD-dominant users were more likely to report illicit drug use, where psilocybin use was markedly different between the two groups.. CBD use was associated with health histories and motivations linked to pain and psychological problems. Positive association between CBD use and illicit drug use may indicate self-medication for psychological conditions. Future studies should evaluate the effectiveness of various CBD forms and dose regimens for treatment of pain and psychological problems, and as a potential intervention for decreasing other drug use and associated harms.

Topics: Adolescent; Adult; Cannabidiol; Cannabis; Cohort Studies; Dronabinol; Female; Hallucinogens; Humans; Longitudinal Studies; Los Angeles; Male; Marijuana Use; Pain; Self Report; Substance-Related Disorders; Young Adult

Topics: Adult; Cannabidiol; Cannabinoids; Cannabis; Cohort Studies; Dronabinol; Female; Humans; Male; Marijuana Use; Massachusetts; Medical Marijuana; Middle Aged

The use and availability of oral and inhalable products containing cannabidiol (CBD) as the principal constituent has increased with expanded cannabis/hemp legalization. However, few controlled clinical laboratory studies have evaluated the pharmacodynamic effects of oral or vaporized CBD or CBD-dominant cannabis.. Eighteen healthy adults (9 men; 9 women) completed four, double-blind, double-dummy, drug administration sessions. Sessions were separated by ≥1 week and included self-administration of 100 mg oral CBD, 100 mg vaporized CBD, vaporized CBD-dominant cannabis (100 mg CBD; 3.7 mg THC), and placebo. Study outcomes included: subjective drug effects, vital signs, cognitive/psychomotor performance, and whole blood THC and CBD concentrations.. Vaporized CBD and CBD-dominant cannabis increased ratings on several subjective items (e.g., Like Drug Effect) relative to placebo. Subjective effects did not differ between oral CBD and placebo and were generally higher for CBD-dominant cannabis compared to vaporized CBD. CBD did not increase ratings for several items typically associated with acute cannabis/THC exposure (e.g., Paranoid). Women reported qualitatively higher ratings for Pleasant Drug Effect than men after vaporized CBD and CBD-dominant cannabis use. CBD-dominant cannabis increased heart rate compared to placebo. Cognitive/psychomotor impairment was not observed in any drug condition.. Vaporized CBD and CBD-dominant cannabis produced discriminable subjective drug effects, which were sometimes stronger in women, but did not produce cognitive/psychomotor impairment. Subjective effects of oral CBD did not differ from placebo. Future research should further elucidate the subjective effects of various types of CBD products (e.g., inhaled, oral, topical), which appear to be distinct from THC-dominant products.

Topics: Administration, Oral; Adult; Cannabidiol; Cross-Over Studies; Double-Blind Method; Dronabinol; Emotions; Female; Humans; Male; Marijuana Use; Nebulizers and Vaporizers; Psychomotor Performance; Volatilization

Cannabis contains over a hundred of different cannabinoids, of which Δ

Topics: Adolescent; Adult; Cannabidiol; Cannabis; Commerce; Dronabinol; Female; Health Status; Humans; Male; Marijuana Abuse; Marijuana Use; Prevalence; United States; Vulnerable Populations; Young Adult

Topics: Adult; Arachidonic Acids; Athletic Performance; Cannabidiol; Cannabis; Doping in Sports; Dronabinol; Endocannabinoids; Exercise; Female; Humans; Inflammation; Male; Marijuana Use; Motivation; Performance-Enhancing Substances; Polyunsaturated Alkamides; Reproducibility of Results; Young Adult

Rates of legal medical cannabis (MC) use are increasing, but little is known about the prevalence and correlates of recreational cannabis (RC) use among medical users (MC/R).. 348 MC users who resided in a state in which MC is legal and had medical authorization to use MC legally completed an anonymous survey in Spring 2017 (64.1% female, 82.8% White, mean age 33.03[±10.37] years). Rates of endorsing MC/R and the following potential correlates of MC/R were examined: the legal status of RC in participants' states of residence, sex, age, race, primary medical condition, MC product(s) used, MC expectancies, features of MC sought out (e.g., high tetrahydrocannabinol [THC] content), and negative cannabis use consequences.. 55.5% of MC users engaged in MC/R. MC/R was associated with residing in a state in which RC is legal, being female, using MC for pain or mental health conditions, vaping MC concentrates, holding positive expectancies for combustible MC, and seeking out MC products with high THC concentrations. Preferring MC products with high cannabidiol (CBD) concentrations protected against MC/R.. More than half of MC users endorsed MC/R, which is considerably higher than rates of misuse observed for other prescription medications. Findings raise concerns about circumvention of RC laws in states where RC remains illegal and could be used to inform MC regulatory efforts (e.g., reducing THC content, increasing CBD content). Findings also suggest that prevention/intervention efforts to reduce MC/R are needed, especially among high-risk populations of MC users (e.g., women, pain patients, psychiatric patients).

Topics: Adult; Cannabidiol; Chronic Pain; Dronabinol; Drug and Narcotic Control; Female; Humans; Male; Marijuana Use; Medical Marijuana; Mental Disorders; Motivation; Prevalence; Risk Factors; Sex Factors; United States; Young Adult

In this contribution, I summarize recent trends of cannabis use in Europe and their public health implications. The first trend refers to an increase of treatment demand for cannabis problems by 76% while prevalence of cannabis use remained largely stable in the same period, based on available data. There are good reasons to assume that this trend reflects increases in the prevalence of cannabis use disorders, however, data to support this claim are not available. Potential drivers for a rising prevalence of cannabis use disorders comprise changes in consumption patterns and increasing levels of THC in available cannabis products. While an increasing prevalence of cannabis use disorders seem likely, the estimates of the Global Burden of Disease studies suggest the opposite. The second trend refers to an emerging market for cannabidiol (CBD) products in European countries, where regulations on CBD are lacking. Given the lack of data on users of CBD products, it can hardly be assessed if current abstainers will initiate using other cannabis products after trying CBD products for medicinal or recreational purposes. However, regulations should be implemented and enforced in order to make CBD products safer for consumers, for instance by ensuring reliable potency levels and by reducing the presence of toxic substances through quality control measures. In summary, a substantial transition of the epidemiology of cannabis use is under way, accompanied by changes in potency, treatment demand and new products. In order to assess the public health implications of this transition, data on population exposure of specific cannabinoids are required.

Topics: Cannabidiol; Drug Trafficking; Europe; Health Services Needs and Demand; Humans; Marijuana Use; Prevalence; Public Health

The expansion of medical and recreational marijuana legalization facilitates patient access to cannabis, and many patients with epilepsy pursue marijuana as a treatment for seizures. We administered a nine-item survey on marijuana use to patients seen in an epilepsy clinic over a 9 month period at a tertiary care center in Oregon where recreational use was legalized in 2015. The majority of respondents (n = 39) reported cannabis use for the purpose of treating epilepsy (87.2%, n = 34), and strongly agreed (53.8%, n = 21) or agreed (28.2%, n = 11) that cannabis use improved seizure control. The most commonly selected cannabis strains were high cannabidiol (CBD) (30.8%, n = 12) or multiple types (30.8%, n = 12), with administration methods of smoking (66.7%, n = 26), edibles (48.7%, n = 19), and concentrates (43.6%, n = 17). More participants reported using marijuana with primarily CBD than primarily tetrahydrocannabinol (THC) or equal CBD:THC content, and very few women reported using marijuana with primarily THC compared with men (10% of female versus 47% of male respondents). Only 2 of 39 participants were able to give an exact dosage used in milligrams. Medical and recreational dispensaries were the most common cannabis sources, followed by homegrown and friends/family members. Although pharmaceutical CBD extract is now Food and Drug Administration (FDA)-approved for certain epilepsy types, access remains limited. Further research is needed to understand recreational cannabis use among patients with epilepsy while clinical research for pharmaceutical cannabis products continues.

Topics: Adult; Aged; Anticonvulsants; Attitude to Health; Cannabidiol; Dronabinol; Epilepsy; Female; Health Care Surveys; Humans; Longitudinal Studies; Male; Marijuana Use; Medical Marijuana; Middle Aged; Oregon; Self Medication; Tertiary Care Centers; Treatment Outcome