Cannabis

(Medscape and JAMA Psychiatry)  June 15, 2018

Cannabis use directly increases the risk for psychosis in teens, new research shows. A large prospective study of teens shows that "in adolescents, cannabis use is harmful" with respect to psychosis risk, study author Patricia J. Conrod, PhD, professor of psychiatry, University of Montreal, Canada, told Medscape Medical News.

The study included 3720 adolescents from the Co-Venture cohort, which represents 76% of all grade 7 students attending 31 secondary schools in the greater Montreal area.

Cannabis use, in any given year, predicted an increase in psychosis symptoms a year later, said Conrod. This type of analysis is more reliable than biological measures, such as blood tests, said Conrod. "Biological measures aren't sensitive enough to the infrequent and low level of use that we tend to see in young adolescents," she said.

The effect was observed for the entire cohort. This finding, said Conrod, means that all young cannabis users face psychosis risk, not just those with a family history of schizophrenia or a biological factor that increases their susceptibility to the effects of cannabis.

"The whole population is prone to have this risk," she said.

In light of these results, Conrod called for increased access by high school students to evidence-based cannabis prevention programs.

The study was published online June 6 in JAMA Psychiatry.

There is a strong association between cannabis use and schizophrenia but the underlying cellular links are poorly understood. Neurons derived from human-induced pluripotent stem cells (hiPSCs) offer a platform for investigating both baseline and dynamic changes in human neural cells. Here, we exposed neurons derived from hiPSCs to Δ9-tetrahydrocannabinol (THC), and identified diagnosis-specific differences not detectable in vehicle-controls. RNA transcriptomic analyses revealed that THC administration, either by acute or chronic exposure, dampened the neuronal transcriptional response following potassium chloride (KCl)-induced neuronal depolarization. THC-treated neurons displayed significant synaptic, mitochondrial, and glutamate signaling alterations that may underlie their failure to activate appropriately; this blunted response resembles effects previously observed in schizophrenia hiPSC- derived neurons. Furthermore, we show a significant alteration in THC-related genes associated with autism and intellectual disability, suggesting shared molecular pathways perturbed in neuropsychiatric disorders that are exacerbated by THC.

Full Article  (cited 26/6/18)

Cannabis is now the most frequently detected illicit drug in drivers involved in motor vehicle crashes. Experimental research and epidemiological data have demonstrated psychomotor impairment associated with THC intoxication and quantified impairment with heightened risk of motor vehicle fatalities. Experimental laboratory studies have repeatedly demonstrated that the primary component of cannabis, Δ9-tetrahydrocannabinol (THC), impairs psychomotor skills including reaction time, focus, executive function, decision making, impulse control, and short-term memory, all important assets needed for safe driving.

Research reveals that the high from marijuana peaks during the first hour after smoking and slowly declines over the following 2 to 5 hours (Hartman and Huestis 2013), sometimes longer. Studies of aircraft pilots who failed to safely execute an emergency landing 24-hours after smoking marijuana should have been the wake-up call we needed regarding the prolonged impairment, in some case 1-2 days after the subjective “high” wears off. But well-financed proponents of marijuana legalization were successful at circumventing the conventions of scientific inquiry to assess safety and efficacy, thus allowing a largely uneducated public to vote the use of this addictive drug into law. As a result, the prevalence of cannabis use is expected to increase as ongoing legalization of both medical and recreational use proceed, despite any scientific evidence regarding the efficacy as a medicine or individual and public safety concerns 

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The acute and long-term effects of THC on the brain and behavior are mediated via the vast endocannabinoid system (ECS), which was not discovered until the early 1990s and remains poorly understood. However, addiction is addiction and the psychopathology associated with marijuana, especially the high potency products, amid the drumbeat for full legalization in the absence of any serious scientific scrutiny is tantamount to political malpractice.

Use can be associated with psychosis, depression, suicidality and premature death…There is not a speck of scientific evidence to suggest that marijuana is a viable “Medically-Assisted Treatment” modality for opioid addiction…like all addictive substances, marijuana degrades neuronal signaling germane to reward incentive and processing, resulting in marked emotional dysregulation. Chronic use is associated with anhedonia, cognitive deficits and psychiatric disease. Marijuana Use Disorder comports with our known model of addiction at every level. The challenge is to educate a public that has been sold a bill of goods and manipulated by claims of efficacy, safety for everything from cancer to pain, without any FDA scrutiny for safety or efficacy

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The Legalization of marijuana in Colorado has introduce a host of problems for the state – problems often glossed over by the pot industry and the regulators and decision makers they finance. Today’s highly potent marijuana represents a growing and significant threat to public health and safety – a threat amplified by a new marijuana industry intent on profiting from heavy use. State laws allowing marijuana has (in direct contradiction to federal law) permitted this industry to flourish. The full extent of the consequences of these policies will not be known for decades!

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