2020 / Review / Preliminary evidenceReview examines the theoretical basis for combining cannabis terpenes with cannabinoids to treat mood and anxiety disorders, finding preclinical support but limited clinical evidence.
2020 / Case Control / Strong evidenceMultisite study of 948 psychosis patients across 6 countries found those who used cannabis had better premorbid social functioning, suggesting social ability may have facilitated cannabis exposure.
2020 / Cross Sectional / Moderate evidenceSurvey of over 26,000 Oregon students found about 75% reported seeing marijuana advertising in the past month after retail legalization, mostly on storefronts and online.
2020 / Observational / Moderate evidenceLab study found five common cannabis terpenes had no detectable activity at CB1 or CB2 receptors and did not modify THC, CBD, or endocannabinoid binding or function.
2020 / Case Report / Preliminary evidenceCase report of a 29-year-old pregnant woman with cannabinoid hyperemesis syndrome caused by chronic cannabis use, highlighting the need to consider CHS in the differential diagnosis of pregnancy-related vomiting.
2020 / Review / Strong evidenceExpert review of 33 studies and 7,500+ patients finds nabiximols safe and effective for MS spasticity when first-line drugs fail, but no scientific evidence supports smoked marijuana for MS.
2020 / Randomized Controlled Trial / Strong evidenceFirst RCT of CBD for cannabis use disorder found 400mg and 800mg daily were safe and more effective than placebo at reducing cannabis use over 4 weeks, with 94% completing treatment.
2020 / Cross Sectional / Moderate evidenceNational Canadian survey found 72% of people with cannabis dependence history achieved remission, but only 43% reached positive mental health, compared to 74% without dependence history.
2020 / Animal Study / Preliminary evidenceMouse study found synthetic cannabinoids combined with alcohol caused worse motor impairment than either alone, mediated by reduced glutamate signaling in the cerebellum via CB1 receptors.
2020 / Systematic Review / Moderate evidenceSystematic review of 10 studies found cannabinoids may improve behavioral symptoms, sleep, and hyperactivity in autism, while reducing seizures in those with comorbid epilepsy, though evidence on core ASD symptoms is limited.
2020 / Animal Study / Preliminary evidenceRat study found CBD reduced cocaine self-administration and reward by attenuating dopamine release in the nucleus accumbens, working through CB2, serotonin 5-HT1A, and TRPV1 receptors.
2020 / Animal Study / Preliminary evidenceLab and animal testing found the synthetic cannabinoid EG-018 has high cannabinoid receptor affinity but behaves as a weak partial agonist, producing limited effects only via intravenous administration.
2020 / Meta Analysis / Strong evidenceMega-analysis of 400 IV THC infusions found psychosis-like symptoms in 45% of healthy volunteers, with effects increasing with dose and decreasing with regular cannabis use history.
2020 / Systematic Review / Moderate evidenceSystematic review of 8 studies with 210 participants found limited evidence for CBD as an antipsychotic but noted its favorable side effect profile compared to standard medications.
2020 / Animal Study / Preliminary evidenceMouse study found CB1 receptor activation and endocannabinoid boosting raised seizure thresholds in Toxoplasma-infected mice, while CB1 blockade worsened seizure vulnerability.
2020 / Pilot Study / Preliminary evidencePilot study of 10 young epilepsy patients found a THC/CBD cannabis preparation was generally safe, with blood levels correlating to dose, supporting the feasibility of therapeutic drug monitoring.
2020 / Cross Sectional / Moderate evidenceStudy of 119 acutely psychotic patients found cannabinoid users showed an unusual inverse relationship between IL-6 inflammation and psychosis severity, with synthetic cannabinoid users more likely to need emergency sedation.
2020 / Systematic Review / Moderate evidenceSystematic review of 34 reports of deaths involving synthetic cannabinoids found no reliable toxic dose ranges could be established, and cause of death often remained unclear.
2020 / Prospective Cohort / Moderate evidenceObservational study of 102 fibromyalgia patients found adding medical cannabis improved sleep in 44%, overall symptoms in 33%, and allowed 47% to reduce other pain medications over 6 months.
2020 / Cross Sectional / Moderate evidenceOntario study found frequent cannabis use in youth aged 12-17 was associated with elevated anxiety, depression, and behavioral symptoms, with associations 2-3 times stronger in girls than boys.
2020 / Retrospective Cohort / Moderate evidencePortuguese hospital data showed cannabis-related psychosis hospitalizations increased 29-fold from 2000 to 2015, rising from under 1% to over 10% of all psychosis admissions.
2020 / Review / Moderate evidenceReview finds prenatal cannabis exposure is not linked to a unique birth defect pattern but is associated with impaired attention and memory, plus increased depression, anxiety, and delinquency in offspring.
2020 / Cross Sectional / Strong evidenceSurvey of 10,035 smokers across 4 countries found higher cannabis co-use in countries with permissive regulations, with tobacco-cannabis mixing far more common in England and Australia than North America.
2020 / Animal Study / Moderate evidenceMouse study found CBD's anti-seizure effects were abolished in mice lacking the TRPV1 receptor, strongly implicating this receptor in CBD's mechanism of action against seizures.
2020 / Review / Moderate evidenceReview identifies potential cannabis interactions with blood thinners: THC may increase warfarin levels (bleeding risk) and CBD may reduce clopidogrel activation (stroke risk) through liver enzyme inhibition.
2020 / Randomized Controlled Trial / Strong evidencePhase II crossover trial found oral THC:CBD capsules nearly doubled complete response for refractory chemo nausea (25% vs 14%), with 83% of patients preferring cannabis to placebo despite more side effects.
2020 / Case Control / Moderate evidenceStudy comparing 201 cannabis-dependent patients to 285 controls found specific methylation differences at dopamine transporter gene sites bound by nervous system development transcription factors.
2020 / Cross Sectional / Strong evidenceNational survey of nearly 88,000 adolescents found cannabis use linked to higher depression and suicide attempts, but the relationship between use frequency and depression was unexpectedly non-linear.
2020 / Case Control / Moderate evidenceStudy of 40 synthetic cannabinoid users found significantly elevated DNA damage, oxidative stress, and inflammatory markers compared to healthy controls, suggesting measurable biological harm from regular use.
2020 / Cross Sectional / Moderate evidenceStudy of 165 schizophrenia patients found substance use disorder quadrupled self-harm risk, with cannabis and synthetic cannabinoids most commonly abused among those who self-injured.
2020 / Review / Moderate evidenceReview of cannabis policy options finds each approach involves trade-offs, with commercialization likely to increase use based on alcohol and tobacco industry precedents, and prohibition reducing use but creating criminal justice harms.
2020 / Cross Sectional / Moderate evidenceCanadian survey data shows the association between monthly cannabis use and depression/suicidal ideation strengthened from 2002 to 2012, with monthly users in 2012 having ~1.5 times the odds of both outcomes vs 2002 users.
2020 / Cross Sectional / Moderate evidenceSurvey of 201 IBD patients found those self-medicating with cannabis had higher impulsivity, more depression, and greater substance misuse vulnerability compared to recreational cannabis users.
2020 / Systematic Review / Strong evidenceUmbrella review of 26 meta-analyses confirms cannabis use is linked to increased psychosis risk, dose-dependent onset, earlier presentation, and higher relapse rates in psychotic patients.
2020 / Cross Sectional / Moderate evidenceStudy of 45 brain tumor patients found cannabinoid receptor expression increased with tumor grade, with CB2 particularly elevated in blood vessels of high-grade astrocytomas.
2020 / Cross Sectional / Moderate evidenceCanadian cancer patient surveys found cannabis use increased 26% after recreational legalization, but access problems also doubled, mainly because preferred products like edibles were not legally available.
2020 / Cross Sectional / Preliminary evidenceExploratory study of 112 dispensary patients found those who reduced alcohol after starting cannabis were more likely to have anxiety, PTSD, and sleep disorders, suggesting a substitution pattern.
2020 / Cross Sectional / Preliminary evidenceSmall study of 59 ADHD patients using medical cannabis found higher CBN consumption was associated with lower ADHD symptom scores, and higher-dose users more often stopped ADHD medications.
2020 / Cross Sectional / Moderate evidenceSurvey of 548 MS patients found cannabis use for symptoms was 4.5 times more likely in recreationally legal states, more common in men and those with severe disability.
2020 / Meta Analysis / Strong evidenceMeta-analysis of 15 controlled studies confirms THC induces psychotic, negative, and general psychiatric symptoms with large effect sizes in healthy people, while CBD shows no consistent protective effect.
2020 / Systematic Review / Preliminary evidenceSystematic review of 10 studies found cannabinoids may reduce PTSD symptoms, especially sleep disturbances and nightmares, but all evidence was of low quality with only one controlled trial.
2020 / Observational / Moderate evidenceStudy of 65 frequent concentrate users found dabbing impaired arm speed for at least 1 hour and balance immediately, with motor impairment poorly correlated to blood THC levels.
2020 / Animal Study / Preliminary evidenceMouse study found cannabinoids were more potent in aged mice than young adults, with stronger pain relief and movement suppression, suggesting elderly users may need lower doses.
2020 / Animal Study / Preliminary evidenceRat study found offspring of THC-exposed fathers showed hyperactivity and cognitive deficits despite mothers never being exposed, suggesting paternal cannabis use before conception can affect offspring.
2020 / Case Report / Preliminary evidenceCase report of a patient in opioid treatment whose persistent fentanyl-positive tests were traced to fentanyl-contaminated street cannabis, resolving after switching sources.
2020 / Narrative Review / Preliminary evidenceNIOSH commentary identified that cannabis legalization outpaced workplace research — drug testing can't measure current impairment, and safety policies lack evidence.
2020 / Animal Study / Moderate evidenceRat study found long-term THC weakened prefrontal cortex control of the brain's reward center while strengthening emotional region (amygdala/hippocampus) input, potentially explaining cannabis-related cognitive and psychiatric effects.
2020 / Review / Moderate evidenceReview of the 2019 EVALI outbreak links cases primarily to vaping unlicensed THC products containing vitamin E acetate, with about 2% mortality and predominant presentation in young men.
2020 / Animal Study / Moderate evidenceRat study found endocannabinoid-boosting drugs reduced persistent fear after predator stress through CB2 (not CB1) receptors, with CB2 gene expression upregulated in the prefrontal cortex by stress.
2020 / Animal Study / Moderate evidenceMouse study found the CB2 agonist LY2828360 synergized with morphine for neuropathic pain relief while blocking morphine reward and partially reducing physical dependence.