Research

  • Marijuana

    Epidemiology

    • Brown et al. 2017
      • Between 2001 and 2013, marijuana use among US adults more than doubled, many states legalized marijuana use, and attitudes toward marijuana became more permissive. In aggregated 2007–2012 data, 3.9% of pregnant women and 7.6% of non-pregnant reproductive-aged women reported past-month marijuana use.
    • Chang et al. 2017
      • Marijuana is the most commonly used illicit substance during pregnancy, however most pregnant women do not disclose marijuana use to their health care providers.
    • Hasin et al. 2018
      • Adults and adolescents increasingly view cannabis as harmless. Evidence suggests national increases in cannabis potency, prenatal and unintentional childhood exposure; and in adults, increased use, cannabis use disorders, cannabis-related emergency room visits, and fatal vehicle crashes. Ecological-level studies suggest that MMLs have led to substitution of cannabis for opioids, and also possibly for psychiatric medications.
    • Young et al. 2017
      • Marijuana is the most commonly used illicit drug during pregnancy, and its use is increasing. Among pregnant women in CA, use almost doubled from 2009-2016 with the greatest increase occurring among women <18 years of age.
    • Salas-Wright et al. 2015
      • In aggregated 2002-2012 data, 14.6% of US pregnant adolescents reported past-month use which is likely an underestimate use due to social desirability bias and underreporting.
    • Ko et al. 2016
      • More than 1 in 10 pregnant and non-pregnant women reported using marijuana in the past 12 months. A considerable percentage of women who used marijuana in the past year were daily users, met abuse and/or dependence criteria, and were polysubstance users.
    • Wall et al. 2011
      • States with Medical Marijuana Laws (MML) had higher average adolescent marijuana use, and lower perception of riskiness, during the period 2002–2008 compared to states without MML.

    Adverse Health Effects of Marijuana

    • Franz et al. 2016
      • Marijuana cigarettes cause increases in heart rate, supine systolic and diastolic blood pressures. Marijuana has been associated with triggering myocardial infarctions (MIs) in young male patients. Smoking marijuana has been shown to increase the risk of MI onset by a factor of 8 for the 60 minutes after marijuana consumption, and to increase the annual risk of MI in the daily cannabis user from 1.5% to 3% per year.
    • Martinasek et al. 2016
      • The research indicates that there is a risk of lung cancer from inhalational marijuana as well as an association between inhalational marijuana and spontaneous pneumothorax, bullous emphysema, or COPD. A variety of symptoms have been reported by inhalational marijuana smokers, including wheezing, shortness of breath, altered pulmonary function tests, cough, phlegm production, bronchodilation, and other symptoms.
    • Murray et al. 2016
      • Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose-response relationship between the level of use and the risk of later psychosis. High-potency cannabis and synthetic cannabinoids carry the greatest risk.
    • Volkow et al. 2014
      • Marijuana use has been associated with substantial adverse effects, some of which have been determined with a high level of confidence. Marijuana, like other drugs of abuse, can result in addiction. During intoxication, marijuana can interfere with cognitive function (e.g., memory and perception of time) and motor function (e.g., coordination), and these effects can have detrimental consequences (e.g., motor-vehicle accidents). Repeated marijuana use during adolescence may result in long-lasting changes in brain function that can jeopardize educational, professional, and social achievements.

    Opioids and Marijuana

    • Lynskey et. al 2003
      • Individuals who use cannabis by the age of 17 are 2 to 5 times more likely to abuse harder drugs and/or alcohol compared to those who do not use cannabis by age 17.
    • Szutorisz et al. 2017
      • In animal studies (Long-Evans rats), parental THC exposure leads to compulsive heroin-seeking in offspring
    • Olfson et al. 2018
      • Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.
    • Bauer et al. 2018
      • Perioperative opioid use was significantly higher in marijuana users despite lower subjective pain scores. The difference in opioid requirements suggests an interaction between marijuana use and opioid tolerance or pain threshold.
    • Caputi et al. 2018 
      • Medical marijuana users were significantly more likely to report medical use of prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug, with elevated risks for pain relievers, stimulants, and tranquilizers.
    • Salottolo et al. 2018
      • These preliminary data suggest that marijuana use, especially chronic use, may affect pain response to injury by requiring greater use of opioid analgesia.
    • Phillips et al. 2017
      • Medical cannabis laws were associated with an increase of 21.7 percent in mean age-adjusted opioid-related mortality
    • Liang et al. 2018
      • Medical cannabis legalization was not associated with a reduction in number of prescriptions for Schedule II opioids
    • Ellgren et al. 2007
      • The current findings support the gateway hypothesis demonstrating that adolescence cannabis exposure has an enduring impact on hedonic processing resulting in enhanced opiate intake.

    Prenatal Marijuana Exposure

    • Brown et al. 2017
      • Between 2001 and 2013, marijuana use among US adults more than doubled, many states legalized marijuana use, and attitudes toward marijuana became more permissive. In aggregated 2007–2012 data, 3.9% of pregnant women and 7.6% of non-pregnant reproductive-aged women reported past-month marijuana use.
    • Chang et al. 2017
      • Marijuana is the most commonly used illicit substance during pregnancy, however most pregnant women do not disclose marijuana use to their health care providers.
    • Young et al. 2017
      • Marijuana is the most commonly used illicit drug during pregnancy, and its use is increasing. Among pregnant women in CA, use almost doubled from 2009-2016 with the greatest increase occurring among women <18 years of age.
    • Salas-Wright et al. 2015
      • In aggregated 2002-2012 data, 14.6% of US pregnant adolescents reported past-month use which is likely an underestimate use due to social desirability bias and underreporting.
    • Ko et al. 2016
      • More than 1 in 10 pregnant and non-pregnant women reported using marijuana in the past 12 months. A considerable percentage of women who used marijuana in the past year were daily users, met abuse and/or dependence criteria, and were polysubstance users.
    • El Marroun et al. 2018
      • Cannabis use in pregnancy poses major health concerns for pregnant mothers and their developing children. This paper provides an epidemiological, developmental and clinical overview on cannabis use during pregnancy.
    • Warner et al. 2014
      • Pro-marijuana advocacy efforts exemplified by the “medical” marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today’s more potent marijuana, which could have significant short- and long-term consequences.
    • Zumbrun et al. 2015
      • Parental or prenatal exposure to cannabis can trigger epigenetic changes that could have significant immunological consequences for offspring as well as long term transgenerational effects.
    • Merrit et al. 2016
      • A review of the evidence regarding the impact of marijuana use during pregnancy and breastfeeding including evidence for adverse effects on infant and child neurodevelopment maturation and cognitive function.
    • Mohr et al. 2018
      •  Prenatal marijuana exposure: Implications for Florida

    Secondhand Marijuana Smoke

    • Glantz et al. 2017
      • Although marijuana is available in many forms, smoking it remains by far the predominant mode of consumption. The cardiovascular effects of secondhand smoke are more important in terms of population impact than cancer, these effects occur quickly, and that marijuana smoke may be worse than tobacco smoke.
    • Wilson et al. 2017
      • Children exposed to secondhand marijuana smoke excrete detectable levels of marijuana metabolites in their urine
    • Merrit et al. 2016
      • In Colorado more than twice as many infants 1-24 months hospitalized for bronchiolitis in 2015 were found to have THC in their urine in after legalization indicating that recreational use contributed to secondhand marijuana smoke exposure in theses infants and thus, a growing health concern.
    • Wang et al. 2016
      • One minute of exposure to marijuana SHS substantially impairs endothelial function in rats for at least 90 minutes, considerably longer than comparable impairment by tobacco SHS.

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