Explore published research on addiction, including study methods and limitations.
Data from 120 subjects showed cannabis tolerance develops and fades quickly, while withdrawal symptoms including insomnia, irritability, and tremor appeared after as few as 7 days of use.
A 1992 review found that despite widespread human use, animals would not self-administer THC and evidence of brain reward pathway stimulation was minimal. The newly discovered cannabinoid receptor was opening new research directions.
Among New York young adults, early alcohol use (ages 13-16) was the strongest predictor of later marijuana and cigarette use, supporting an age-dependent gateway pattern.
Among 1,481 heavy smokers trying to quit with nicotine patches, marijuana users had half the odds of success. Early lapse (3+ cigarettes in first 4 weeks) predicted relapse in 96%.
Among 75 marijuana users who lapsed after treatment, those who blamed themselves and saw the cause as permanent and pervasive were more likely to return to regular use over six months.
Self-efficacy for avoiding marijuana predicted frequency of post-treatment use better than complete abstinence. Cognitive-behavioral treatment only marginally improved confidence.
Among vocational high school students, 65% were heavy smokers by age 13, with strong associations with alcohol and marijuana use, poor grades, and multiple failed quit attempts.
Cannabis use before age 15 was associated with 2.7-30.8 times higher odds of mental health and behavioral problems, but most of this risk was explained by pre-existing family disadvantage and early adjustment difficulties.
Prescription THC (dronabinol) showed no evidence of abuse, diversion, or street demand. Its slow onset and dysphoric effects made it unappealing even to cannabis-dependent individuals.
In nearly 2,000 female twins, whether someone tried cannabis was shaped by environment, but progression to heavy use and dependence was 62-79% heritable, driven primarily by genetics.
A pharmaceutical review found marijuana causes dependence but has less addictive power than cocaine, alcohol, heroin, or nicotine, and shows therapeutic promise for six conditions.
A major review found THC caused cell death in the hippocampus, produced persistent cognitive deficits, and activated the same dopamine reward pathways as morphine, alcohol, and nicotine.
In 199 smokers trying to quit, alcohol use predicted failure at all follow-up points. Marijuana use, whether at baseline or during treatment, did not predict smoking cessation outcomes.
Among 842 high-risk students, 70% used marijuana, over half had tried to quit and failed, and most viewed cessation programs as ineffective despite high interest in quitting.
Among drug treatment patients, 64% had alcohol dependence, 44% antisocial personality, and 24% depression. Cannabis dependence was higher in Caucasians and males, while women had higher depression and anxiety.
In 1,198 male twin pairs, trying cannabis was influenced by family environment, but heavy use and dependence were 60-80% genetic, mirroring identical findings in female twins.
In 50 bipolar patients, alcohol abuse correlated with time spent depressed while cannabis abuse correlated with time in mania, suggesting each substance interacts differently with bipolar mood states.
In one of the only controlled studies of suicidal substance abusers, fluoxetine reduced depression, suicidal ideation, alcohol, and marijuana use, with benefits lasting one year.
Econometric study using cigarette prices as a natural experiment found evidence that smoking leads to cannabis use, but weak evidence that cannabis use leads to harder drugs, challenging gateway theory.
Population-based study of 232 first schizophrenia episodes finding double the rate of substance abuse compared to controls, with cannabis used by 88% of drug abusers and drug use often preceding illness onset.
Animal study showing a compound from passionflower reduced THC tolerance, dependence, and withdrawal symptoms in mice, suggesting potential for cannabis withdrawal treatment.
A 21-year study of 1,265 New Zealand children found cannabis use linked to crime, depression, suicidal behavior, and other drug use, with younger users (14-15) affected more than older users (20-21).
Twin study of 3,360 male pairs finding that the genetic link between depression and cannabis/alcohol dependence was largely explained by shared genetic risk for antisocial personality disorder.
Review finding that blocking or removing CB1 receptors enhanced memory performance, suggesting the endocannabinoid system normally constrains memory formation, while also modulating opioid dependence.
Electrophysiology study showing cannabinoids strongly inhibited excitatory inputs to the brain's reward center through CB1 receptors, independent of dopamine and opioid systems.
Review finding that smoking cessation did not increase relapse to other substances and continued smoking actually worsened marijuana treatment outcomes, supporting integrated treatment.
Stopping heavy cannabis use was linked to withdrawal that began within 1–3 days, peaked in Days 2–6, and typically resolved by two weeks.
Comprehensive review documenting reliable THC self-administration in monkeys and major cannabinoid-opioid-dopamine interactions underlying reward and dependence.
Review proposing cannabis may be a gateway to tobacco rather than the reverse, with university student research suggesting cigarette initiation often followed marijuana use.
Twin study of 2,125 pairs finding cannabis-other drug comorbidity is best explained by shared genetic and environmental risk factors rather than gateway causation.
Early case series: vomiting stopped in most after stopping cannabis and returned on rechallenge, with hot bathing reported by nearly all.
Qualitative study finding Scottish teenagers' cannabis and tobacco smoking were "inextricably linked," with cannabis use serving as a gateway to cigarettes and a barrier to quitting tobacco.
A 2004 psychiatry review concluded that stopping heavy cannabis or THC use brings a reproducible withdrawal syndrome and proposed diagnostic criteria.
Controlled study showing oral THC relieved marijuana withdrawal symptoms (anxiety, insomnia, craving, appetite loss) without intoxication, while divalproex worsened mood and cognition.
Adolescent but not adult cannabinoid exposure in rats produced lasting cross-tolerance to morphine, cocaine, and amphetamine in dopamine reward neurons, suggesting unique adolescent brain vulnerability.
5-year follow-up finding 42% of teen marijuana users quit, with heavier use, male gender, being unmarried, and friends' use predicting continued consumption.
Study of 357 first-episode psychosis patients found 44% met criteria for substance abuse/dependence, primarily involving cannabis and alcohol, with higher rates in younger males.
PET imaging study found heavy marijuana users (53-84 joints/week) still had brain activity changes and decision-making deficits after 25 days abstinent, while moderate users performed like non-users.
Study of 627 respondents found that people who underreported marijuana use also underreported tobacco use, with self-report accuracy falling below previously established thresholds.
Review of animal studies found cannabinoid tolerance develops through receptor down-regulation, withdrawal symptoms are generally milder than with other drugs, and tolerant animals showed no increased vulnerability to morphine.
fMRI study found cocaine-dependent individuals who also used cannabis showed decreased frontal cortex activation during emotional stress, even after 15+ days of abstinence.
Comparative review found cannabis primarily impairs attention and memory, stimulants affect processing speed and flexibility, and heroin impacts impulse control, with severity increasing with heavier use.
Comprehensive review found strong evidence linking cannabis to psychosis, supported the existence of cannabis withdrawal syndrome, and called for more rigorous research on prevention and treatment.
Study of adolescent cannabis treatment seekers found nearly two-thirds experienced four or more withdrawal symptoms, though rates were lower than in adult studies.
Review of twin and family studies found a genetic basis for every stage of cannabis involvement, with some genetic risk factors shared across cannabis, alcohol, tobacco, and other drugs.
UK study of 152 first-episode schizophrenia patients found 68% had lifetime drug use, with cannabis independently predicting earlier psychosis onset after adjusting for other substance use.
Vouchers drove abstinence during treatment. Adding CBT helped keep it going over the next year.
Mouse study found the anabolic steroid nandrolone blocked THC reward and increased withdrawal severity without changing CB1 receptor binding, suggesting downstream signaling interactions.
Two-year study of 615 heroin users found reducing heroin use was associated with decreased use of most other drugs, not substitution. Cannabis and alcohol use were independent of heroin changes.
Four large trials of CB1 blocker rimonabant showed significant weight loss, improved lipids and blood sugar, and increased smoking quit rates. Later withdrawn due to psychiatric side effects.
Norwegian twin study found genetic factors accounted for 58-81% of variation in illicit drug use and dependence, replicating findings from higher-prevalence countries like the US and Australia.
fMRI validation study confirmed cocaine, nicotine, and cannabis users show identical hemodynamic brain responses to controls during finger-tapping, validating drug-user neuroimaging comparisons.
Comparison of drug detection methods found dramatic underreporting of drug use versus hair analysis results. Cocaine detection by hair was excellent; cannabis detection required specialized metabolite analysis.
Study of Nigerian army veterans from peacekeeping operations found 22% had PTSD, which was significantly associated with longer deployment, alcohol use, and lifetime cannabis use.
Review of nicotine-cannabis interactions found co-use may enhance reinforcing and anxiolytic effects while having opposite effects on appetite and cognition, with adolescent co-use being a major concern.
Large twin study found common genetic factors drive adolescent problem use across tobacco, alcohol, and marijuana, while shared environmental factors drive experimentation but not progression to problems.
National survey of 43,093 Americans identified five drug abuse patterns, with cannabis-only (5.8%) being the most common and mildest, while polysubstance (0.5%) was linked to the most severe psychiatric profiles.
Study of 119 heavy cannabis users found high rates of depression (46%) and suicidality (42%), predicted by parental alcoholism and childhood adversity rather than cannabis or other drug use.
Review described how the endocannabinoid system drives reward-seeking in both addiction and obesity, making targeted CB1 modulators promising but challenging drug candidates.
Mouse study found THC enhanced MDMA reward at low doses but reduced it at high doses, with both drugs converging on dopamine signaling in the brain's reward center.
Genome-wide scan of high-risk families found overlapping chromosomal regions linked to both alcohol and cannabis dependence, particularly on chromosomes 2 and 10, suggesting shared genetic vulnerability.
Five-year follow-up of 166 bipolar patients found cannabis use specifically preceded manic episodes, while alcohol preceded depressive episodes, with neither following mood episodes.
Simulated drug market study found cannabis demand was quality-sensitive, with users switching to alcohol when cannabis quality dropped, while alcohol demand was unaffected by quality changes.
National survey of 2,613 frequent cannabis users found 44% experienced clinically significant withdrawal symptoms, with identical rates among cannabis-only users, supporting its diagnostic recognition.
Review of brain science behind cannabis addiction found that cannabinoid receptor systems undergo specific neuroadaptive changes with chronic use, overturning the notion that cannabis is non-addictive.
Comprehensive review found cannabinoids only produce reward in animals under narrow conditions, unlike other drugs of abuse, explaining their classification as "atypical" addictive substances.
Review mapped the genetics of cannabis disorders: linkage regions on seven chromosomes and candidate genes in both the cannabinoid system (CNR1, FAAH, MGLL) and general addiction pathways.
Twin study developed a 50% heritable alcohol consumption measure that correlated with cannabis and nicotine use, supporting shared genetic vulnerability across substances.
Among 3,427 young women, those who used cannabis and tobacco simultaneously had 1.6x higher cannabis abuse risk, driven by environment (31%) rather than genetics (0%).
Survey of Nigerian prison inmates found 7% current cannabis use with 71% heavy users, rates barely lower than pre-imprisonment, and cannabis was uniquely associated with criminal history patterns.
Among 1,779 adolescents in substance abuse treatment, those who continued or started smoking cigarettes had significantly higher odds of relapsing on marijuana and alcohol at 12 months.
A literature review described cannabis addiction as a chronic brain disease involving dopamine and serotonin pathways, with chronic use producing lasting effects on cognitive and reward brain circuits.
A dual FAAH/MAGL inhibitor produced THC-like effects including drug discrimination responses that neither single-enzyme inhibitor could achieve, revealing cooperative endocannabinoid signaling.
Alcohol cue imagery increased anandamide levels and correlated with craving in 11 social drinkers, but this endocannabinoid response was absent in 12 abstinent alcoholics with markedly reduced baseline levels.
In a 12-week trial of 50 marijuana-dependent participants, buspirone showed a non-significant trend toward more negative drug tests overall, but a significant effect among those who completed treatment.
Opioid-dependent patients who used cannabis intermittently during naltrexone treatment stayed 133 days vs 35 days for abstainers or consistent users, replicating a previous finding.
Among 350 medical cannabis patients, 66% used cannabis as a substitute for prescription drugs, 40% for alcohol, and 26% for illicit drugs, citing fewer side effects and better symptom control.
THC withdrawal induced the Narp gene in the amygdala, the same response seen with opiate and nicotine withdrawal, suggesting a shared molecular mechanism across drug withdrawal.
Among 464 cannabis users from a twin-family study, those who experienced stronger subjective effects were 3-12 times more likely to become heavy users, even after controlling for genetic risk.
Heroin users showed fearful-avoidant attachment, ecstasy users showed mixed insecure patterns, and cannabis users were mainly dismissing or secure, suggesting different drugs serve different emotional regulation needs.
Among 3,459 bipolar patients followed for 12 months, cannabis users had less treatment compliance, more mania, more psychosis, and higher overall illness severity with little evidence of confounding.
Endocannabinoid blockade reduced positive and increased negative emotional responses in mice, effects that were altered by chronic nicotine exposure, suggesting interactions between the two systems in mood regulation.
A 20-year-old developed dependence on Spice Gold over 8 months, with physical withdrawal including elevated blood pressure (180/90), tachycardia (125 bpm), sweating, and tremor resembling cannabis withdrawal.
A WHO study across 17 countries found the gateway drug sequence varies with drug availability and cultural factors, suggesting common causes rather than cannabis itself driving progression to harder drugs.
Both psychosis patients and controls showed negative implicit cannabis associations, but patients had stronger explicit negative awareness. Relaxation expectancies were the strongest predictor of actual cannabis use in both groups.
In 37 abstinent cannabis users, genetic variants in CNR1 and FAAH genes were associated with greater brain reward-area activation when viewing marijuana cues, with an additive effect of risk alleles.
Meth neurotoxicity increased 2-AG endocannabinoid levels and alcohol consumption in mice, effects that were blocked by a CB1 receptor antagonist and mimicked by a MAGL inhibitor.
A review described how chronic nicotine and alcohol each alter cannabinoid receptors, endocannabinoid content, and multiple other brain systems, reducing each other's withdrawal and increasing preference for combined use.
In 6 cannabis users, nabilone produced THC-like subjective effects and substituted for THC in drug discrimination, while methylphenidate did not, supporting nabilone as a potential cannabis dependence medication.
Review of how endocannabinoid and opioid systems modulate nicotine addiction, suggesting new treatment targets.
The FAAH inhibitor URB597 helped rats forget morphine associations during extinction but did not prevent relapse when exposed to morphine again.
Urine testing showed lower illicit heroin co-use in heroin maintenance (50%) versus methadone maintenance (71%), while cannabis use stayed high in both.
fMRI study found chronic cannabis users had heightened brain reward responses to money and reduced sensitivity to losses compared to non-users.
Review identified three cellular mechanisms of cannabinoid-opioid interaction: peptide cross-release, receptor-receptor interaction, and converging signaling pathways.
Daily marijuana users with past alcohol problems drank 52% more during marijuana abstinence; those without alcohol history showed no increase.
Twin study of 6,257 people found genetics explain over 60% of cannabis use and dependence variation, with substantial genetic overlap with alcohol.
Cannabis-dependent people with depression had worse social functioning but performed better on some cognitive tests than those without depression.
Cannabinoid withdrawal physically shrank VTA dopamine neurons and reduced dendritic spines in the nucleus accumbens shell, supporting a "hypodopaminergic" addicted brain model.
THC-dependent monkeys discriminated withdrawal as a distinct state; cannabinoid agonists and clonidine blocked it, but sedatives and cocaine did not.
Review warned that synthetic cannabinoids in "Spice" products were more potent than natural cannabis, showed addiction potential, and posed identification challenges.
Meta-analysis of 28+ twin studies found genetics explained 40-48% of cannabis initiation and 51-59% of problematic use, with environment more influential for initiation.
Comprehensive search found extremely rare nabilone abuse after nearly 30 years of availability, with no street value and minimal law enforcement concern.
First GWAS of cannabis dependence tested nearly 1 million genetic variants in 3,054 people, finding suggestive signals but no definitive genetic associations.
The Cannabis Withdrawal Scale was developed with excellent reliability, revealing nightmares as the most diagnostic symptom and angry outbursts as the most distressing.
Among 432 male veterans, less PTSD improvement during treatment predicted greater cannabis use at 4 months, specifically linked to avoidance/numbing and hyperarousal symptoms.
Boosting endocannabinoids with URB597 reduced anxiety but not physical symptoms during nicotine withdrawal in rats, with anandamide fluctuating across multiple brain regions.
Case report tracked executive function from 24 hours to 12 weeks of cannabis abstinence, showing progressive cognitive improvement with clinical implications for treatment.
Prenatal cannabis decreased D2 receptor expression in human fetal brain reward center; in rats, THC during pregnancy caused lasting epigenetic changes increasing offspring addiction vulnerability.
The generic EQ-5D quality measure only moderately captured quality of life in 103 schizophrenia patients with cannabis abuse, missing domains like relationships and finances.
Review for family doctors found cannabis helped chronic/neuropathic pain with addiction risk, and highlighted cannabinoid-opioid synergy that could reduce opioid dependence.
First agonist substitution trial for cannabis dependence: dronabinol did not increase abstinence but improved retention (77% vs 61%) and reduced withdrawal symptoms.
Endocannabinoid enhancement reduced depression-like behavior during nicotine withdrawal in mice through serotonin 5-HT1A receptor interaction, suggesting combined targeting for smoking cessation.
Mouse study found that boosting natural endocannabinoids reduced opioid withdrawal symptoms, with the 2-AG pathway more effective than anandamide.
Review documenting that cannabis dependence and withdrawal are clinically real, though THC's slow clearance delays and obscures symptoms.
Review of Sativex clinical data found low intoxication, 2.2% euphoria rate, no tolerance, and no withdrawal, suggesting low abuse potential.
Lab study found cannabinoid activation protected brain cells during alcohol withdrawal, while blocking the cannabinoid system worsened damage.
Rat study found cocaine withdrawal increased cannabinoid receptors and disrupted synaptic plasticity in the amygdala, potentially driving cue-triggered relapse.
In 23 cannabis users, Sativex showed similar or slightly less abuse potential than equivalent doses of dronabinol (pure synthetic THC).
Rat study found FAAH inhibitor URB597 reduced most morphine withdrawal symptoms across a broad dose range.
Review finding buspirone was the only medication with controlled trial evidence for cannabis dependence, with several others warranting further study.
In 49 dependent users, greater day-to-day disruption from withdrawal was linked to relapse and to heavier use one month later.
Critical examination of the gateway drug theory, arguing that common research designs cannot adequately control for confounding factors that explain the association.
CB1 antagonist reversed nicotine locomotor sensitization in novelty-seeking rats but failed to reduce and actually worsened nicotine-induced anxiety.
Among 1,015 substance users, 27% had headaches (94.5% starting after drug use), with cannabis use duration specifically linked to higher headache rates.
Structured interviews revealed cannabis use disorders and PTSD were significantly underdiagnosed in VA medical records for 84 military veterans.
Comprehensive Mayo Clinic review of cannabis therapeutics, addiction, psychosis, and policy, noting the gap between public approval and scientific evidence.
Brain activity in cognitive control regions predicted which heavy cannabis users would develop worse problems over 6 months, beyond what craving alone predicted.
Review finding combination therapies (motivational + cognitive-behavioral + incentives) most effective for cannabis dependence, though long-term abstinence remains below 20%.
Twin study of 5,638 found the link between borderline personality and cannabis use is genetically driven, while the alcohol connection is environmental.
Synthetic cannabinoids JWH-018 and JWH-073 produced THC-like effects in monkeys but lasted only 1-2 hours versus THC's 4, potentially increasing addiction risk.
In cannabis-dependent men, rimonabant blood levels correlated with cortisol increases, providing human evidence that CB1 receptors modulate the stress hormone system.
Review of Spice/K2 effects found anxiety and psychosis reports, while three cases showed cannabis-dependent users found synthetics relieved their withdrawal.
In adolescents with new-onset bipolar disorder, cigarette smoking predicted development of cannabis and alcohol disorders, while quitting smoking did not worsen mood.
In 739 smokers, marijuana use did not affect quitting success, while alcohol use after quitting increased smoking urges and relapse risk.
Chronic daily smokers showed lower cortical CB1 receptor availability that returned to control-like levels after about four weeks without cannabis.
CB1 antagonist reversed anxiety from stress hormones and cocaine withdrawal in rats through brain mechanisms independent of the hormonal stress axis.
Review finding cannabis enhanced opiate pain relief, prevented tolerance, and potentially reduced opiate dependence, positioning it as a harm-reduction strategy.
Large Australian twin study found 72-80% heritability for cannabis use, early onset, and abuse/dependence, among the highest for any substance.
French study of 29,393 teens found daily cannabis users were 124 times more likely to try other illicit drugs, modeled through a stage-based progression.
Objective measurement of cannabis smoking showed front-loaded puffing and dose-dependent prediction of withdrawal severity, especially sleep disruption.
Open-label pilot of pericyazine for cannabis dependence showed reduced use and improved mood in 21 patients, warranting a randomized controlled trial.
Young people seeking treatment for cannabis dependence typically had multiple psychiatric diagnoses, especially anxiety disorders like PTSD and social phobia.
Animal data place cannabis squarely in the dopamine reward circuit: dopamine rises with use and cues, and falls during withdrawal. Blocking endocannabinoid signaling blunts these effects.
Twin study found over 60% of the shared vulnerability to alcohol, tobacco, and cannabis dependence was driven by common genetic factors.
Comprehensive review found the brain's endocannabinoid system plays a key role in alcohol's rewarding effects and is altered by chronic drinking.
Eighteen months of heroin treatment reduced heroin, cocaine, and benzodiazepine use, but cannabis and alcohol consumption remained unchanged.
Alcohol withdrawal reduced endocannabinoid system gene expression in the rat amygdala, with repeated withdrawal cycles causing worse disruption.
Largest early CH series: frequent long-term use common, abdominal pain prevalent, 91 percent of those who tried hot bathing reported relief. Follow-up was scarce.
Longitudinal study found the order of trying drugs did not predict cannabis use disorder; peer influence was the key factor.
Adolescent THC exposure in rats altered gene regulation through epigenetic changes in the reward system, directly increasing vulnerability to heroin self-administration.
Review found effective medications for nicotine, alcohol, and opioid dependence, but none approved for cannabis or cocaine dependence.
Blocking cannabinoid receptors improved memory deficits during morphine withdrawal in mice, with chronic treatment being more effective than a single dose.
A study of 7,452 twins found none of 10 previously reported cannabis-associated genes replicated, suggesting earlier findings were likely false positives.
Twin study found shared genetic risk for nicotine, alcohol, and marijuana peaked at ages 14-17 and declined into adulthood as substance use became more environmentally driven.
Safety review found Sativex was well-tolerated for MS spasticity with no evidence of dependence, dose escalation, or significant withdrawal upon stopping.
CB1-expressing neurons in the brain's reward center are fast-spiking interneurons that become hyperexcitable during cocaine withdrawal, potentially suppressing reward circuit output.
Brain imaging showed heavy cannabis users activated habit-related brain regions for positive cannabis associations while non-users activated deliberate control regions.
Four-year study of 1,145 college students found cannabis use predicted late enrollment gaps while depression predicted early ones.
Study of 984 college students found "study drug" use was linked to escalating cannabis and alcohol problems and declining academic performance, not academic ambition.
In regular cannabis smokers, nabilone showed more dose-related and sustained effects than dronabinol, supporting its potential as a cannabis dependence medication.
Review detailed how enzyme-specific inhibitors revealed different roles for anandamide and 2-AG in pain, anxiety, and addiction, guiding therapeutic development.
Cannabis-dependent veterans with PTSD used cannabis more for coping, experienced worse withdrawal, and had stronger cravings than veterans without PTSD.
Among 100 veterans attempting to quit cannabis, positive beliefs about cannabis effects predicted use, lapse, and relapse, while negative beliefs had limited impact.
Cannabis cues increased craving and activated memory and emotion brain regions, but the brain-craving relationship habituated after the first exposure.
Among 385 adults who tried to quit cannabis without treatment, self-image, health, and legal motivations predicted better outcomes, with gender differences in motivation.
Quetiapine improved sleep and appetite during cannabis withdrawal but increased craving and use during the relapse phase, disqualifying it as a dependence treatment.
Hypothesis paper proposed PEA, a natural fatty acid with endocannabinoid properties, as a potential treatment for cannabis dependence and withdrawal.
Females often show stronger cannabinoid effects. Estradiol is a leading explanation in animals, while human evidence remains mixed.
PCP users showed significantly higher rates of intimate partner violence and legal problems compared to cannabis-only and alcohol/cannabis polysubstance users.
Abstinent adolescents with past cannabis use disorder showed abnormal brain patterns during risk-taking and reward processing that persisted after treatment.
Chronic cannabinoid treatment in monkeys caused up to 250-fold tolerance and cross-tolerance with methamphetamine and dopamine D2 drugs.
Trait impulsivity in 385 bipolar patients was strongly linked to cannabis misuse (p<0.0001), alcohol misuse, rapid cycling, and mixed episodes, but not suicide.
Children of substance-using parents showed reduced error-processing brain activity even before any cannabis use, suggesting an inherited vulnerability marker.
Adolescent cannabis users showed increased self-reflection brain activity when hearing their own motivational statements, and this predicted less use one month later.
Ontario surveys found 15.5% of students and 5.9% of adults reported prescription opioid misuse, with cannabis use predicting misuse in male adults.
In 1,103 French youth followed 18 years, childhood attention problems predicted adult tobacco and cocaine use, while early cannabis exposure predicted all substance outcomes.
Tobacco smokers were 19 times more likely to relapse to marijuana in a lab setting, but tobacco's direct effects did not explain this, suggesting shared vulnerability.
Nabilone (6-8 mg/day) reduced both marijuana withdrawal symptoms and self-administration in the relapse phase, with low abuse potential and once-daily dosing.
A case study using on-off-on-off cycles found cannabis and cigarette use decreased during micronutrient supplementation and resumed when supplements stopped.
Among 80 adolescents with bipolar disorder and cannabis use, 49% were heavy tobacco smokers and 70% were nicotine dependent, with smoking marking greater severity.
Among 72 cannabis-dependent veterans, impulsivity correlated with craving and earlier cannabis use onset but did not predict quit success over 6 months.
CB2 cannabinoid receptors were required for nicotine reward but not withdrawal in mice, with an opposite role for cocaine reward, revealing substance-specific effects.
In a 43,070-person U.S. survey, past-year mental illness was linked to much higher cannabis use and disorder rates, and to most of the cannabis consumed.
FAAH inhibition enhanced nicotine reward in mice but blocked it in rats, with species differences possibly due to non-cannabinoid substrates like OEA and PEA.
CB2 knockout mice showed no nicotine reward, reduced self-administration, and no withdrawal, with CB2 receptors colocalizing with nicotinic receptors in reward circuits.
Twin study found a common genetic factor drove vulnerability to alcohol, tobacco, and cannabis dependence, with genetic influence increasing from 43% to 63% through adolescence.
In 1,803 children followed 15 years, oppositional behavior was the strongest predictor of cannabis and cocaine dependence, while the ADHD link was largely explained by opposition.
53% of young adult tobacco users also used marijuana, and co-users had 25% lower odds of planning to permanently quit tobacco.
Study protocol for examining cannabis withdrawal in Indigenous Australian prisoners using a pictorial withdrawal scale and cortisol biomarkers.
NAC helped adolescents achieve more marijuana abstinence without reducing craving more than placebo, suggesting it works through non-craving mechanisms.
Cannabis use during methadone stabilization did not harm treatment outcomes and pilot data suggested it may have reduced opiate withdrawal symptoms.
Among 670 injection drug users in Tijuana, marijuana smokers were 38% more likely to have attempted quitting tobacco, a counterintuitive finding.
Occasional stimulant users with high cannabis co-use showed the most brain inefficiency during reward-based decision-making, suggesting additive substance effects.
A review described cannabinoid hyperemesis syndrome, a condition in long-term cannabis users featuring severe cyclical vomiting and compulsive hot bathing that is often underdiagnosed.
A researcher hypothesized that beta-lactam antibiotics might reduce cannabis dependence by boosting brain glutamate transporters, based on parallels with opioid pharmacology.
In heavy cannabis users, both THC and cocaine increased impulse control errors, suggesting acute intoxication with either drug may reduce the ability to resist impulsive decisions.
Twin study found cannabis withdrawal was about 50% heritable, with 99% overlap between genes influencing withdrawal and those influencing abuse/dependence.
Rats showed increased CB1 receptor expression in a brain reward center throughout morphine withdrawal, and blocking these receptors reduced drug-seeking behavior.
Twin study found that initial reactions to tobacco predicted both nicotine and cannabis dependence, while cannabis reactions predicted only cannabis outcomes, with 27-35% heritability for first-use reactions.
Social network analysis of college students found marijuana and alcohol use clustered within friend groups, while exercise did not, suggesting substance use is more socially contagious.
In 376 college students, inattention symptoms were independently linked to worse cannabis outcomes and strengthened the connection between use level and cannabis-related problems.
In 14 regular users, lower dopamine synthesis in associative striatum tracked with higher apathy. No control group, and dose measures did not explain apathy.
Adolescent smokers who frequently used marijuana were 44% less likely to have attempted quitting cigarettes, with boys showing a stronger effect than girls.
A man with 16 years of severe vomiting and compulsive hot showering from CHS remained completely symptom-free for nine years after quitting marijuana.
Review found sleep disturbance and substance use disorders reinforce each other, with cannabis withdrawal showing objective sleep disruption and insomnia treatment identified as a gap.
Women gave higher "Good" and "Take Again" ratings than men after smoking cannabis in controlled conditions, despite identical intoxication — suggesting sex-specific vulnerability to cannabis's reinforcing effects.
In 3,080 twins, both ADHD symptoms and autistic traits independently predicted cannabis use disorders, while autistic traits showed a paradoxical pattern of less alcohol use but higher dependence risk.
Landmark review found CBD showed anticonvulsant, anxiolytic, antipsychotic, and anti-addictive properties but lacked well-powered trials, setting the stage for the clinical program that led to FDA approval.
Among 69 veterans on buprenorphine for opioid addiction, positive marijuana urine tests, benzodiazepine use, smoking, and psychiatric comorbidity predicted treatment noncompliance.
In mice, orexin-1 signaling supported cannabinoid reward. Blocking it reduced self-administration and erased THC-evoked accumbens dopamine.
Smokers who used marijuana and other drugs expected quitting cigarettes would cause adverse outcomes, reducing their quit motivation across all six substance categories tested.
A patient with chronic vomiting previously diagnosed as cyclic vomiting syndrome was found to have cannabinoid hyperemesis syndrome, highlighting the importance of cannabis screening.
Pilot study found that adding tobacco treatment to cannabis treatment did not harm cannabis outcomes, with 5 of 6 participants achieving cannabis abstinence.
Among 25,456 high schoolers, marijuana use was associated with twice the odds of gambling and gambling problems, alongside alcohol and prescription drug misuse.
Clozapine reduced cannabis craving and insula brain activity more than risperidone in patients with schizophrenia and cannabis use disorder over 4 weeks of treatment.
Among 290 adolescents with eating disorders, nearly half of those with bulimia nervosa reported substance use, with older age being the strongest predictor of regular use.
Longitudinal study found marijuana use predicted dating aggression in girls, hard drug use predicted it in boys, and alcohol predicted aggression timing for both sexes across grades 8-12.
Study of 11 daily cannabis smokers found that oral THC (dronabinol) increased blood cannabinoid levels dose-dependently, but smoked cannabis was only distinguishable from oral THC for about 1 hour.
RCT of 185 patients found an 8-session CBT intervention did not outperform treatment as usual for substance users with suicide risk on any measure over 6 months.
Population study of 1,560 young adults found lifetime crack cocaine use (2.5% prevalence) was associated with PTSD, antisocial personality disorder, suicide risk, and polysubstance use including cannabis.
Case report of a 32-year-old woman who developed takotsubo (stress) cardiomyopathy during an episode of cannabinoid hyperemesis syndrome after resuming marijuana use.
Canadian study found teens with ADHD reported cannabis use at 14.2%, comparable to or lower than the 16.5-26.0% rates in two general population samples.
Mouse study found acute and repeated cocaine exposure produced distinct endocannabinoid and glutamate system changes in the cerebellum, implicating it in addiction processes.
Among 972 young adults using both cigarettes and marijuana, use patterns were correlated but quit motivation diverged: more desire to quit cigarettes but less confidence in success.
Review of 165 studies found drug addiction involves both disrupted endocannabinoid signaling and neuroinflammation, suggesting cannabinoids could address addiction through anti-inflammatory mechanisms.
Study of 11,667 middle schoolers found perceived peer norms predicted substance use in younger teens, while direct exposure to substance-using peers became more influential with age.
Among 502 first-episode psychosis patients, cannabis users who reduced or stopped use after treatment contact showed the greatest symptom improvement at one year.
Study of 3,146 college students found 30% had used marijuana before college and 8.5% started during freshman year, with campus residence as a key risk factor for initiation.
Review of 7 randomized trials found Project TND consistently reduced hard drug use in all trials, with less consistent effects on alcohol (4/7) and marijuana (2-3/7).
Unexposed offspring of THC-exposed rats showed compulsive heroin-seeking behavior and altered striatal brain circuitry, suggesting transgenerational epigenetic effects of parental cannabis exposure.
Review found synthetic cannabinoids are full CB1 agonists with higher potency than THC (a partial agonist), explaining their increased potential for adverse reactions and toxicity.
Analysis of 72,053 high school seniors found simultaneous use of alcohol and marijuana was associated with the highest rates of unsafe driving, exceeding concurrent or single-substance use.
Study of 463 adolescents found COMT gene methylation was linked to smoking, and a specific genotype-methylation interaction influenced high-frequency cannabis use.
Survey of 514 CVS patients found 81% used marijuana, reporting symptom improvement. Hot showers were used by 67%, more commonly among marijuana users but not exclusively.
RCT of 7,079 students across 7 European countries found "Unplugged" reduced cannabis use, smoking, and drunkenness, with cannabis and alcohol effects persisting at 15 months.
Case report of CHS presenting as cyclical vomiting relieved by hot baths in a chronic cannabis user, emphasizing the need for emergency department recognition.
Double-blind trial of 52 cannabis-dependent users found escitalopram (SSRI) added to CBT did not improve abstinence rates (19% overall), anxiety, or depression compared to placebo.
Cannabis cues flashed for 33ms (below conscious awareness) activated reward brain circuits in dependent users, with activation correlating with craving and years of use.
CB1 neutral antagonists reduced the aversive emotional effects of morphine withdrawal in rats, but FAAH inhibitors (which boost anandamide) did not.
Review proposes nabiximols (THC/CBD spray) as cannabinoid replacement therapy for cannabis dependence, analogous to methadone for opioid dependence, with controlled dosing and pharmaceutical standardization.
Case report and literature review outlining cannabinoid hyperemesis syndrome: severe cyclic vomiting in chronic cannabis users, relieved by hot bathing, resolved by cessation.
A group cessation program for 77 cannabis-tobacco co-smokers achieved 23% abstinence at 6-month follow-up, with improvements in mental health and substance use.
Brain scans of 17 daily cannabis smokers identified a neural signature that distinguished decisions to purchase cannabis from decisions to decline with 100% accuracy.
Case of a woman with CHS whose chronic vomiting caused dangerous electrolyte imbalances that had to be corrected before she could undergo jaw surgery.
Dronabinol reduced opioid withdrawal severity during detox but did not improve naltrexone treatment completion rates in 60 opioid-dependent participants.
Among 104 cannabis-dependent veterans, PTSD predicted higher baseline use and slower initial reduction after a quit attempt, but did not affect relapse timing.
Adolescent THC exposure affected heroin reward differently in addiction-prone vs. resilient rat strains, suggesting genetics determine whether cannabis acts as a gateway.
Brain scans of 15 chronic cannabis users showed reduced activation in error-monitoring and memory regions during a learning task, with lower error-correction rates than controls.
PET brain imaging showed chronic cannabis users had 11.7% fewer available CB1 receptors globally, with reductions of 11-14% in temporal, cingulate, and reward regions.
Econometric analysis of 1907-1918 Punjab data found opium and hashish were economic substitutes: when hashish prices rose, opium consumption increased.
Web-based addiction treatment improved abstinence 3.6x for stimulant users with promising trends for cannabis (2.6x) and alcohol (3.2x), but had no effect for opioid users.
In 9,583 Australian twins, cannabis involvement was modestly associated with suicidal ideation and unplanned attempts, partly explained by shared genetic and environmental vulnerabilities.
A 17-year-old had 5 ER visits for vomiting and weight loss before CHS was diagnosed, illustrating how underrecognized the condition is in adolescents.
Analysis of 116 patients found cannabis use did not reduce opioid withdrawal symptoms during a 10-week methadone taper, with results robust across 17 sensitivity analyses.
Longitudinal study of 816 people found externalizing disorders (conduct problems) predicted cannabis use disorder onset from ages 16-30, while depression and anxiety did not.
35-year birth cohort study of 1,265 New Zealanders found regular cannabis use associated with lower education, unemployment, and psychotic symptoms, but many regular users experienced no harm.
A 29-year-old presented with the classic CHS triad of cyclic vomiting, chronic cannabis use, and compulsive bathing, reinforcing the need to consider this diagnosis in chronic users.
Review of endocannabinoid system role in nicotine addiction found rimonabant helped smokers quit but had psychiatric risks, prompting research into safer alternative cannabinoid targets.
Review found acute cannabinoid use impairs habit-based learning while chronic use enhances it, suggesting a novel habit-memory mechanism for cannabis addiction.
Among 371 juvenile detainees, cannabis use was 54% lifetime and 16% daily, far above general population rates, with daily users showing worse mental health but not more criminal involvement.
Among 96 bipolar manic patients, the dysphoric-psychotic subtype had higher rates of combined alcohol-cannabis use disorders and more suicide attempts than the pure elevated mania subtype.
Among 772 college freshmen, moderate drinkers who also used marijuana had significantly more blackouts, injuries, and DUIs than moderate drinkers who did not use marijuana.
U.S. adult cannabis use more than doubled by 2012-2013. Use disorders nearly doubled in the population, while the share of users with a disorder fell from 36% to 31%.
Analysis of 1.3 million VA patients found more opioid prescriptions associated with higher rates of cannabis use disorder, suggesting the substances complement rather than substitute.
Nursing guide to CHS emphasizes that standard antiemetics fail, narcotics may worsen pain, and abstinence from marijuana is the most effective treatment for this underrecognized condition.
Among 480 Spanish undergraduates, 46% used multiple substances with cannabis-inclusive patterns most common, and use strongly correlated with close family and friends' substance use.
Study of 101 incarcerated Indigenous Australian men found family responsibilities and incarceration were the strongest motivators for quitting cannabis, suggesting culturally tailored cessation programs are needed.
Swedish study of nearly 80,000 twin and sibling pairs found that 75-90% of genetic risk for drug abuse is shared across cannabis, stimulants, and sedatives rather than being drug-specific.
24-month study found regular cannabis use significantly lowered remission rates in bipolar spectrum disorders, with the worst outcomes among those using both cannabis and tobacco.
Qualitative study found Baby Boomer cannabis users consciously substituted cannabis for alcohol, prescription drugs, and illicit substances, perceiving it as safer and less addictive.
Pilot study of 32 participants found that simultaneously treating cannabis and tobacco addiction was feasible and did not worsen cannabis outcomes, while reducing tobacco use.
Survey of 1,811 young adult smokers found 46% called themselves social smokers but smoked alone too. Both social smoker groups were more likely to use and be dependent on marijuana.
Auckland detox services saw 47 synthetic cannabinoid withdrawal presentations in one year, with 20 requiring inpatient care. It became the third largest detox admission category.
Vaporized THC at higher doses helped rats extinguish opiate withdrawal memories, while injected THC at a moderate dose prolonged them fourfold, highlighting route-dependent effects.
Rat study found estrogen and progesterone promoted THC dependence and withdrawal symptoms, while testosterone appeared protective, potentially explaining sex differences in cannabis withdrawal.
Cannabis use remained stable during the first year of methadone treatment, linked to opioid use and health problems rather than methadone itself, suggesting self-medication.
Study of 94 methadone patients found cannabis users had significantly lower methadone blood levels, potentially affecting treatment effectiveness. No heroin use was reported above specific concentration thresholds.
National survey found 28% of African American substance users used both marijuana and tobacco, with co-users showing higher marijuana dependence and earlier age of initiation.
Review found alcohol promotes inflammation while cannabinoids suppress it, suggesting cannabinoid-based therapies could potentially counteract alcohol-induced immune damage.
Genetic analysis of 2,596 people found common gene variants explain 25-36% of drug dependence vulnerability, with genetic effects almost entirely shared across substances.
Review found no approved cannabis addiction medications but identified promising targets including FAAH inhibitors and allosteric CB1 modulators in animal models of reward, withdrawal, and relapse.
Canadian national survey found 3.9% past-year depression prevalence, with about 5% of depressed individuals also having cannabis use disorders. 63% sought treatment but 38% perceived stigma.
Review found tobacco and cannabis each promote dependence on the other through shared brain chemistry, common smoking route, and bidirectional gateway effects.
Study of 144 adolescent offenders in Spain found 78.5% used drugs, with psychotic teens preferring cannabis and ADHD teens gravitating toward cannabis plus cocaine.
Among homeless people in BC, cannabis users had 32% psychotic disorder rates linked to childhood neglect, while stimulant users were more likely female and poly-substance users.
Both inverse agonist and neutral antagonist precipitated withdrawal in cannabis-dependent mice, showing withdrawal results from receptor competition, not inverse agonism, and is centrally mediated.
Alcohol and cannabinoid signaling showed opposing effects at inhibitory synapses in the rat amygdala, with each system blocking the other's actions.
Brain imaging revealed that heavy cannabis users lacked the balanced dopamine receptor signaling between striatal regions that healthy controls displayed during a reaction-time task.
THC and a 2-AG boosting drug reduced brain reward self-stimulation in mice, while boosting anandamide alone had little effect, all mediated through CB1 receptors.
Bipolar patients who quit cannabis during a manic episode had outcomes similar to never-users over two years, while those who continued using had lower recovery, higher recurrence, and more work impairment.
Blocking CB1 receptors reduced binge alcohol and sucrose consumption in adolescent mice to adult levels, suggesting the endocannabinoid system drives age-related differences in binge drinking.
The atypical cannabinoid O-1602, a GPR55 receptor agonist, reduced morphine reward and physical dependence symptoms in mice, suggesting a potential new target for opioid dependence.
Among 100 hospitalized male bipolar patients, current substance use tripled violence risk, with cannabis, alcohol, and synthetic cannabinoids as the most common substances.
A clinical review examined the evidence on adolescent cannabis use in the context of expanding legalization, covering risks, legal frameworks, and clinical considerations.
A clinical review found cannabinoids offer modest benefits for nausea and inconsistent benefits for pain, while risks include cognitive impairment, driving accidents, dependence, and psychosis.
In a nationally representative sample, alcohol was the most common first substance among US 12th graders, and earlier alcohol initiation predicted significantly greater illicit drug involvement.
A study of 34,000+ US adults found cannabis use predicted a 6.2x higher risk of substance use disorders over three years, but was not associated with mood or anxiety disorders.
A meta-analysis found cannabis use associated with 2.6x suicide death risk, 1.4x suicidal ideation risk, and 2.2x suicide attempt risk, with heavy use approximately doubling these figures.
Rats exposed to cannabis smoke at human-relevant THC levels showed biphasic activity changes, reduced anxiety, and developed physical dependence confirmed by precipitated withdrawal signs.
Among 80 rehab patients, those with ADHD started using substances earlier, and earlier cannabis onset in ADHD patients predicted more severe later cannabis and cocaine use.
Mothers' tobacco and alcohol use predicted earlier alcohol onset in children, while fathers' marijuana combined with alcohol use was also significant, challenging the focus on paternal risk.
Genetic risk scores for schizophrenia predicted cannabis and cocaine involvement, while depression genetic risk predicted cannabis use and severe cocaine dependence, in 2,573 participants.
Expert clinicians discussed the assessment and management of an adolescent marijuana use disorder, sharing clinical reasoning in a case conference format.
Synthetic cannabinoid dependence and withdrawal are underrecognized problems with no established treatment, though benzodiazepines and quetiapine may provide some relief.
Heavy users showed lower brain CB1 receptor availability at baseline, but the difference from controls disappeared after two days without cannabis.
PET imaging showed cannabis-dependent males had 15% fewer CB1 receptors than controls, but receptors normalized to control levels after just 2 days of abstinence.
Analysis of 38,681 DEA-seized samples showed cannabis THC tripled from ~4% to ~12% between 1995–2014 while CBD nearly disappeared.
Among 273 pregnant former smokers, 14% had a lifetime cannabis use disorder, with having multiple psychiatric disorders as the overwhelming strongest predictor (36x odds).
Among 5,677 young Swiss men, ADHD was independently associated with earlier drug initiation, riskier use patterns, and more substance disorders, even after controlling for antisocial personality.
National survey data from 2002-2014 showed probationers and parolees had substance use disorder rates four to nine times higher than the general population, with marijuana dependence significantly elevated but still less common than alcohol disorders.
A 3-year prospective study of the US population found cannabis use was not associated with increased risk of developing anxiety disorders, though people with panic disorder were more likely to start using cannabis.
A review found limited but promising evidence that pregabalin may help manage cannabis and other drug withdrawal symptoms, though the medication's own misuse potential in substance-dependent populations warrants caution.
A case report of an adolescent using dabs, THC edibles, and heavy smoking who developed severe cannabinoid hyperemesis syndrome raises concerns that high-potency products may trigger the condition faster and in younger users.
Rhesus monkeys receiving morphine plus THC developed faster pain relief tolerance than those on morphine alone, but THC did not worsen opioid withdrawal when treatment stopped.
A case report describes how cannabinoid hyperemesis syndrome in a bipolar patient caused three weeks of vomiting that lowered mood stabilizer levels, likely triggering a manic episode.
Among 3,418 college students, five substance use patterns emerged, with a notably stable cluster of students who primarily co-used little cigars, hookah, and marijuana.
A rigorous multi-site trial found that oral CBD at doses up to 800 mg did not reduce the high, reinforcing effects, or cardiovascular impact of smoked cannabis in regular users.
The first nationally representative US study using DSM-5 criteria found 2.5% of adults had a past-year cannabis use disorder, with strong links to psychiatric comorbidity and disability, yet only 13% ever sought treatment.
Review of animal and human evidence shows chronic alcohol disrupts the endocannabinoid system, and CB1 receptor blockade reduces alcohol consumption and relapse, though psychiatric side effects remain a barrier to clinical use.
A chronic cannabis user visited the ER three times with severe cyclic vomiting before being diagnosed with cannabinoid hyperemesis syndrome, illustrating the cost of poor CHS awareness among providers.
An inpatient study found that combining the sleep aid zolpidem with the synthetic THC pill nabilone reduced cannabis withdrawal symptoms and decreased cannabis self-administration more than zolpidem alone.
First reported case of successful outpatient treatment of cannabinoid hyperemesis syndrome using haloperidol, in a patient who was unwilling to stop cannabis and had failed standard anti-nausea medications.
A survey of 2,572 Bahamian secondary school students found that both alcohol and marijuana use were independently associated with sexual behavior, supporting integrated prevention approaches.
Among 247 first-episode psychosis patients, escalating marijuana use in the 5 years before onset was strongly linked to faster psychosis development, with daily use doubling the rate independent of other substance use.
Review examines how alcohol treatment drugs (disulfiram, acamprosate, naltrexone) interact with cannabinoids, finding potential relevance for cannabis use disorder but limited clinical evidence.
A 9-year study of 357 heroin users in Vancouver found cannabis use doubled the risk of starting heavy drinking, while methadone treatment did not increase alcohol use as feared.
A survey of 5,080 Canadian adults found that hyperactive/impulsive ADHD symptoms predicted problematic cannabis use in men, while inattentive symptoms predicted it in women, revealing sex-specific pathways.
Review reveals cannabis may enhance hippocampal learning during use (strengthening drug-context memories) while impairing it during withdrawal (driving relapse), creating a cycle that maintains addiction.
First rigorous study shows THC acutely reduces motivation temporarily, while cannabis dependence is associated with impaired reward learning but preserved overall motivation when sober.
A rigorous trial of 122 cannabis-dependent adults found that combining synthetic THC (dronabinol) with lofexidine was no more effective than placebo for achieving cannabis abstinence, though both groups improved with behavioral therapy.
A year-long systematic study of drug-related ER visits in a Swiss hospital found cannabis was the most commonly detected substance (33%), though novel psychoactive substances were rarely involved.
A survey of 473 Canadian medical cannabis patients found 87% used cannabis as a substitute for other substances, with 80% replacing prescription drugs, 52% replacing alcohol, and 33% replacing illicit substances.
First systematic analysis of online forums found 25% of posts claim cannabis helps ADHD versus 8% saying it is harmful, despite zero clinical evidence supporting cannabis as an ADHD treatment.
First controlled comparison found adolescents felt less stoned and had fewer memory problems from cannabis than adults, but showed impaired impulse control and no feeling of having had enough, potentially driving escalated use.
Meta-analysis of 37 studies found one-third of first-episode psychosis patients use cannabis, with regular use typically starting 6.3 years before psychosis onset and declining by nearly half after treatment.
ADHD medication (mixed amphetamine salts) was associated with more marijuana-free weeks in people with co-occurring ADHD and cocaine dependence.
Among HIV-positive adults over 50 in care, marijuana was the most commonly used illicit drug (32.6%), and more than a third of users had never received substance use treatment.
Case report and literature review of cannabinoid hyperemesis syndrome, where chronic cannabis use paradoxically causes severe cyclical vomiting resolved only by cessation.
French pilot study shows a specialized addiction team in the ED identified 7 CHS cases in 7 months, with 5 of 7 patients entering addiction follow-up care.
Study of 7,672 inmates finds DSM-5 and ICD-10 agree on severe and no-diagnosis cannabis cases but disagree on moderate disorders, with half mapping to dependence and half to harmful use.
Large clinical trial finds cannabis-using tobacco smokers quit tobacco at the same rate as tobacco-only smokers when given standard cessation treatment.
Study of 101 opioid-dependent people in India found cannabis became the most commonly used substance during imprisonment (35%), overtaking opioids (19%), with 65% using drugs while incarcerated.
Adolescent THC exposure in rats enhanced adult cannabinoid self-administration and blunted dopamine reward signaling, providing a biological mechanism for increased addiction vulnerability after early cannabis use.
A CB1 neutral antagonist reduced both nicotine and cannabis seeking in monkeys without affecting food motivation, offering a potentially safer alternative to the withdrawn drug rimonabant.
An endocannabinoid-boosting compound being studied as a potential anti-smoking treatment was itself self-administered by monkeys, raising concerns about abuse potential of this drug class.
Large longitudinal study reveals sex-specific patterns: daily cannabis use predicted 4-fold increased suicidal ideation risk in men, while suicidal ideation predicted cannabis initiation in women.
In 1,285 ED patients, hair analysis and self-reported drug use agreed well for cannabis and street opioids but poorly for cocaine, with people most accurately reporting their primary drug of choice.
Longitudinal study of 936 college freshmen finds pre-college marijuana use predicted hookah initiation in the first month of college, alongside alcohol as the only other predictor.
In a teen marijuana cessation trial, NAC-treated adolescents who reduced marijuana use also reduced alcohol use, with no compensatory increase in drinking.
Largest cannabis GWAS (32,330 people) identified four genes and found genetics explain 13-20% of cannabis use variation, with 83% genetic overlap with cigarette smoking.
Among 1,134 French college students, cannabis use was strongly associated with e-cigarette experimentation (2.44x odds), and nearly half of e-cigarette experimenters had never smoked cigarettes.
Proof-of-concept trial shows high fixed doses of Sativex significantly reduced cannabis withdrawal symptoms but not craving, with self-titrated doses proving insufficient.
Boosting the endocannabinoid 2-AG did not affect nicotine self-administration but significantly enhanced cue-triggered nicotine seeking in mice, implicating 2-AG in tobacco relapse.
Among 369 disadvantaged Australian smokers, 19% used cannabis concurrently (100% simultaneously), and cannabis use was associated with lower motivation but not lower intention to quit tobacco.
Longitudinal study finds e-cigarette use by Hispanic young adults predicted nearly 2x higher odds of starting marijuana and 3x higher odds of starting cigarettes one year later.
Study of 2,722 Hispanic youth finds that increasing or persistently high discrimination trajectories from age 14-23 predicted higher marijuana, alcohol, and hard drug use.
Brain response to cannabis cues in the left striatum predicted cannabis problem severity 3 years later, independent of how much cannabis was used, suggesting a neural biomarker for addiction risk.
Study of 5,103 Swiss men finds ADHD predicted initiating new substances (especially amphetamines) over 15 months, independent of conduct disorder, without escalating existing substance use.
Review finds CBT-based psychotherapy has moderate-to-large effects on cannabis dependence (evidence level Ia), no pharmacotherapy is approved, and serotonergic antidepressants may worsen outcomes.
Survey of 848 NZ police detainees found 20% of synthetic cannabinoid users reduced or stopped natural cannabis use, suggesting modest substitution, though SC users had higher baseline cannabis consumption overall.
Survey of 105 frequent legal high users in Auckland found 58% of synthetic cannabinoid users met dependence criteria, with common reports of insomnia (29%), nausea (25%), and anxiety (21%).
Study of 686 drug-using ED patients found cannabis-only users had lower severity than other drug users, but 19-29% still had problematic use, especially daily users who showed lower self-efficacy.
A 25-year cohort study found childhood conduct problems and adolescent attention difficulties independently predicted problematic cannabis use by age 25.
In identical twin pairs, the twin who used cannabis frequently was about twice as likely to have depression and 2.5 times as likely to report suicidal thoughts, even after controlling for shared genetics.
Suicide attempts predicted later development of substance dependence (including cannabis), but early substance use showed limited evidence of predicting future suicidal behavior.
College students who viewed young adulthood as a time for experimentation were more likely to use marijuana and binge drink, while those focused on identity exploration used less marijuana.
A variant in the cannabinoid receptor gene CNR1 was linked to more frequent cannabis use at age 18, but the genetic effect did not change the trajectory of use over the following six years.
Controlled study showing oral CBD up to 800mg produced no abuse-related effects in frequent marijuana users, supporting CBD's favorable safety profile.
Protracted withdrawal from THC, morphine, nicotine, and alcohol produced similar behavioral and molecular patterns in mice, while cocaine withdrawal was strikingly opposite.
Chronic cannabis users showed weakened brain connections between motivation centers and both frontal and visual processing areas, but these changes began normalizing after one month of abstinence.
Comprehensive review establishing cannabis withdrawal as a neurobiologically grounded syndrome with a 4-week CB1 receptor recovery timeline, gender differences in severity, and limited but promising pharmacological treatments.
Prospective study of young Mexicans found cannabis use before age 15 was associated with nearly 4x risk of suicidal ideation and 5x risk of suicide attempt over eight years of follow-up.
In a 20-year cohort study, adolescent self-harm independently predicted weekly cannabis use at age 35, the only outcome that survived adjustment for adolescent mental health and behavior problems.
Daily cannabis use predicted suicidal ideation through feeling like a burden to others, but only when combined with feeling disconnected, supporting a psychological theory of cannabis-related suicide risk.
Cannabis use disorder diagnoses in US hospitals nearly tripled from 2002-2011, with psychiatric disorders as the top comorbidity and patients trending older and sicker.
Comprehensive review finding a disconnect between cannabis's "soft drug" reputation and growing evidence of cognitive impairment, psychosis risk, and gateway effects, particularly in youth.
Both CB1 blockade and CB2 activation independently reduced cocaine reward and motor stimulation in rats, revealing complementary cannabinoid-based strategies for addressing cocaine addiction.
Turkish versions of the CUPIT and CPQ cannabis screening tools showed good reliability and validity for both cannabis and synthetic cannabinoid use disorder patients.
Review arguing that cannabis harms mood, cognition, psychiatric health, and driving, and that public perception of low risk is unsupported by the scientific evidence.
Canadian Paediatric Society review documenting that adolescent cannabis use causes brain changes and is associated with dependence, mental illness, cognitive decline, and academic underperformance.
In 140 first-episode psychosis patients, cigarette smoking was independently linked to worse cognition and functioning after adjusting for cannabis use, with 53% of patients smoking.
Cannabis use among Americans over 50 surged between 2006-2013, with a 250% increase among those 65+, while most older users perceived little to no risk.
Narrative review finding substantial evidence linking cannabis to psychosis and other drug use, mixed evidence for depression and anxiety, with adolescent onset carrying the greatest psychiatric risk.
Dispensary study of 217 patients finding younger medical cannabis users consume more and show more problematic use than older users, with early initiation as a key risk factor.
Animal study revealing sex-specific endocannabinoid system responses to alcohol withdrawal, with males showing anxiety and neurochemical disruption while females were protected by ovarian hormones.
20-year cohort study of 1,229 people identifying distinct risk profiles for persistent (6.7%), limited (13.3%), and delayed (3.7%) problematic cannabis use, with anxiety predicting persistence and childhood trauma predicting late onset.
Large RCT across 32 Australian schools finding that a three-year resilience-building intervention produced no significant reductions in marijuana, tobacco, alcohol, or other substance use among 2,105 students.
Case report of haloperidol successfully treating cannabinoid hyperemesis syndrome when standard treatments failed, highlighting a potential new option for this increasingly recognized condition.
Review consolidating behavioral research on synthetic cannabinoids, finding evidence for abuse potential, tolerance, dependence, and toxicity that often exceeds THC, with significant knowledge gaps remaining.
Study of 3,233 veterans finding cannabis use disorder independently associated with 2.3 times higher odds of suicide attempts, even after controlling for PTSD, depression, and other substance use.
Study of 366 young adults finding medical cannabis patients used more frequently and spent more than recreational users, but also vaped more and showed trends toward less prescription drug misuse.
Screening of 22,095 primary care patients in Washington State finding 15.3% past-year cannabis use and 3.1% daily use, with rates reaching 36% among young adults and 32% among young men with depression.
Review explaining that synthetic cannabinoids are full agonists with higher binding affinity than THC (a partial agonist), producing more intense effects and more severe neurological and cardiovascular complications.
Comprehensive review finding strong evidence from human and animal studies that adolescent cannabis exposure causes lasting deficits in cognition, emotion, and psychosis risk that do not occur with adult-onset exposure.
Mouse study showing the endocannabinoid system in the hippocampus undergoes opposite changes during morphine reward (increased endocannabinoid breakdown) versus relapse (increased CB1 receptor expression).
Longitudinal study of 158 young men finding escalating adolescent cannabis use disrupted reward-prefrontal brain connectivity, predicting more depression, anhedonia, and lower education at age 22.
Meta-analysis of 23 independent samples finding interactive school-based prevention programs produced a small but significant reduction in middle school cannabis use (d=-0.07), with teacher-delivered programs being most effective.
Survey of 271 Canadian medical cannabis patients finding 63% used cannabis as a substitute for prescriptions (30% opioids, 16% benzodiazepines), with 42% also buying from illegal sources.
Study of 61 schizophrenia patients finding those with heavy pre-psychosis cannabis use had fewer neurological signs and better cognitive function, suggesting cannabis-associated psychosis may be a distinct disease subtype.
Study of 260 first-episode psychosis patients finding early cannabis use and BDNF met-allele independently predicted younger psychosis onset, with early cannabis use more common in males.
Analysis of 12 million treatment records finding increasing youth marijuana admissions from 1995-2012 alongside dramatically decreasing drug severity, suggesting lower referral thresholds rather than worsening problems.
Analysis of national data finding rising Hispanic youth marijuana treatment admissions from 1995-2012, with female admissions growing faster than male, linked more to school/community referrals than severe drug problems.
Validation of a new 46-item questionnaire identifying six categories of cannabis cessation expectations, providing clinicians a tool to understand barriers to quitting.
Monitoring the Future data showing college became a dramatically stronger risk factor for marijuana initiation after 2013, with 51% increased risk by 2015 compared to 17-22% historically.
Twin study of 2,793 young adults finding the cannabis-psychosis link is explained by shared genetics (55% correlation) plus a direct effect from cannabis use disorder to psychotic experiences, not the reverse.
Longitudinal study of 711 people showing cannabis use at 17 led to drug-using friendships at 22, which predicted starting cocaine, meth, or opiates by 27, supporting a social rather than pharmacological gateway mechanism.
Mouse study showing MAGL inhibition (boosting 2-AG) produces cannabis-like subjective effects through CB1 receptors, while FAAH inhibition (boosting anandamide) does not, revealing MAGL as a "brake" preventing endocannabinoid intoxication.
Review arguing that cannabis and stimulant drugs damage well-being through the same core mechanism: cyclical mood disruptions that chronically stress the body's hormonal and neurological systems.
Large survey of nearly 39,000 Asian adolescents found cannabis use under 1%, with cigarette smoking the only universal predictor across all five countries studied.
Survey of 1,513 medical cannabis patients found over 75% reduced opioid use and 65-72% reduced sleep and anxiety medications, though their primary care doctors often did not know.
Prospective study found that opioid-dependent patients who also used synthetic cannabinoids experienced significantly longer withdrawal and craving during detoxification.
Survey of nearly 2,900 medical cannabis patients found 97% reported being able to reduce opioid use with cannabis, and 81% found cannabis alone more effective than the combination.
Mouse study found that memory problems during nicotine withdrawal are driven by increased endocannabinoid (2-AG) signaling through CB1 receptors on inhibitory neurons, with associated loss of dendritic spines.
National survey found current marijuana users had double the tobacco use (69% vs. 28%) and one-third the sustained cessation rate (22% vs. 66%) compared to never-marijuana users.
Review of cannabis withdrawal neurobiology finding CB1 receptor downregulation drives withdrawal symptoms, recovery occurs with abstinence, and women may experience faster and more severe symptoms.
Among 302 adults entering cannabis treatment, women had significantly more severe withdrawal, more psychiatric disorders, and more pain than men despite identical cannabis use patterns.
Longitudinal study of 2,539 teens found neighborhood drug problems predicted marijuana use, but personal resistance confidence and avoiding drug-using peers buffered these effects.
Review of clinical trial evidence finding THC-containing medications effective for cannabis withdrawal, promising for opioid withdrawal, and identifying rimonabant's failed potential for smoking cessation.
The biology linking the endocannabinoid system to PTSD was strong, but clinical evidence for cannabis as treatment was weak. Nabilone showed real promise for nightmares specifically.
Survey of 22,224 Mexican university students found earlier substance initiation predicted current use and polysubstance use, with males significantly more likely to use marijuana.
Pilot trial found a family-based intervention with emotional regulation skills reduced marijuana use and risky behaviors among justice-involved youth over 3 months.
National survey found regular marijuana smoking associated with 34% higher odds of poor self-rated health even without tobacco, rising to nearly double with concurrent tobacco use.
PET imaging study found severely cannabis-dependent individuals had markedly reduced striatal dopamine release (effect size 1.48), correlating with cognitive deficits and negative symptoms.
Survey of 7,488 African American students found 18.5% past-year marijuana use, with parent, teacher, and school protective factors significantly reducing risk.
Review finding synthetic cannabinoids are more potent, more dangerous, and more psychiatrically harmful than natural cannabis, with rapid chemical evolution evading regulation.
Mouse study found a dual endocannabinoid-boosting compound reduced pain, enhanced morphine's effects at low doses, and decreased heroin-seeking behavior.
Rat study found that blocking CB1 receptors in the BNST (a brain stress region) prevented the aversive experience of opioid withdrawal, while boosting 2-AG in the same region did not.
In 777 methadone patients, cannabis use was linked to 82% higher odds of illicit opioid use in women but showed no association in men.
Among 100 men on long-term buprenorphine, cannabis users (35%) had comparable opioid outcomes, employment, and quality of life to non-users, despite lower buprenorphine doses.
Cannabis-using psychosis patients were initially diagnosed with severe mental illness at lower rates (20% vs 53%), but both groups reached 80% severe diagnoses by second hospitalization.
A novel CB1 neutral antagonist reduced binge alcohol drinking and dopamine reward signaling in mice without the psychiatric side effects of previous CB1 blockers.
Systematic review of 108 studies found consistent links between substance use (including cannabis) and suicidal ideation and behavior across low- and middle-income countries.
Four-year study of 1,514 chronic pain patients on opioids found cannabis users had worse pain, more anxiety, and lower self-efficacy, with no evidence of opioid reduction.
Analysis of 10,511 substance-related ED visits found cannabis third most common (14.4%) after alcohol and opioids, with sex-specific age differences in presentation patterns.
National study tracked marijuana transitions: 2.4% of never-users initiated, 10.4% of former users returned, and 72.5% continued over one year, with early initiation and frequent use predicting persistence.
Six-year follow-up of 161 early psychosis patients found cannabis use predicted more hospital readmissions and longer stays, especially in male and Black patients.
Overview found cannabinoids produce dose-dependent acute effects on anxiety, mood, and cognition, with chronic use linked to tolerance, dependence, withdrawal, and associations with psychiatric disorders.
Rural college students started with lower marijuana use than urban peers as freshmen but matched their rates by junior year, with perceived peer use as the strongest predictor of escalation.
Longitudinal study of 247 families found prenatal tobacco effects were stronger in girls, and a bidirectional cycle where toddler behavior problems predicted increased maternal cannabis use.
French national survey found cannabis use predicted failed smoking cessation, while successful quitters were distinguished by no e-cigarette use, no environmental smoke exposure, and perceived harmfulness of smoking.
Twin study of 3,762 adolescents found childhood ADHD predicted earlier marijuana use, but identical twin analysis indicated shared genetics, not ADHD itself, primarily drive the link.
Population study of 3,723 people with anxiety disorders found cannabis use did not predict worse remission after adjusting for baseline differences, though cannabis use disorder linked to relationship and educational disruption.
Case-control study found a CB1 receptor gene variant associated with cannabis use and higher DNA methylation at dopamine receptor genes in users, plus protective effects of education and female sex.
Study of 1,669 ED patients found cocaine and cannabis use, both individually and combined, associated with significantly higher 36-month mortality risk after demographic adjustment.
National survey found parental cannabis use rose from 4.9% to 6.8% (2002-2015) while cigarette smoking declined, with cannabis use nearly 4 times higher among smoking parents.
Survey of 155 daily marijuana smokers at an urban ED found 32.9% met criteria consistent with cannabinoid hyperemesis syndrome, estimating 2.75 million Americans may be affected annually.
Review proposed CBD as treatment for cannabis users with early psychosis, based on evidence of antipsychotic properties and ability to counteract THC's psychotogenic, anxiogenic, and cognitive effects.
Major review documented US increases in cannabis potency, use disorders, ER visits, and fatal crashes alongside growing perception of harmlessness, while medical marijuana laws showed no effect on adolescent use.
Two-year chart review found 19.4% of ED vomiting patients reported cannabis use, with 43% of regular users having repeat visits and extensive workups suggesting widespread CHS underdiagnosis.
Pilot study of 25 adolescent psychiatric inpatients found 76% substance use and 36% illicit drug use, with cannabis predicted by family dysfunction and substance use linked to suicidal ideation.
Longitudinal study found higher schizophrenia genetic risk predicted stronger cannabis use increases during ages 16-20, with no relationship to alcohol or tobacco, supporting shared genetics between schizophrenia and cannabis use.
Twin study found cannabis use disorder is 78% heritable, but 83% of genetic risk overlaps with genes affecting opportunity and frequency of use, with only 17% unique to the disorder.
Study of 169 men found brain volume loss in the prefrontal cortex was linked to total number of substances used, not any single drug. Cannabis showed no independent effect after controlling for polysubstance use.
Case report demonstrated successful treatment of cannabinoid hyperemesis syndrome with IV haloperidol after psychiatric consultation clarified the diagnosis.
Cannabis use disorder was the only factor consistently associated with self-injury across all models in Iraq/Afghanistan veterans, with odds ratios of 3.10 for suicidal and 5.12 for nonsuicidal self-injury.
Population survey of 5,196 adults found ADHD did not predict arrest history, but cannabis misuse did, with a stronger effect in women than men.
Expert consensus guideline recommended capsaicin as first-line CHS treatment, haloperidol/olanzapine as alternatives, avoidance of opioids, and patient education that cannabis cessation is the only lasting solution.
fMRI study found cannabis use disorder participants showed altered prefrontal-striatal brain connectivity during working memory, with compensatory increases in some pathways offsetting decreases in others.
EEG study found cannabis users with high distress intolerance showed enhanced brain conflict-monitoring under stress, which was linked to fewer cannabis problems, challenging the stress-impairment model of addiction.
Randomized study found clozapine reduced cannabis craving and amygdala cue reactivity significantly more than risperidone in schizophrenia patients with cannabis use disorder.
Critical review found CBD shows distinct promise for psychosis, anxiety, and withdrawal symptoms, each through different pharmacological mechanisms, but needs larger controlled trials.
Study of 203 daily cannabis users found that the tendency to experience negative emotions explained why people with low distress tolerance have more cannabis problems, worse withdrawal, and less confidence in quitting.
Human Connectome Project analysis found cannabis-dependent individuals had hyperconnectivity in dopamine-related brain regions (striatum, midbrain), most pronounced in those who started youngest and reported high negative emotionality.
Study of 721 college users found tobacco-marijuana co-users prioritized quitting cigarettes over marijuana, with higher importance ratings but lower confidence for cigarette cessation. Different factors predicted quitting each substance.
Study of 459 SUD patients found a graded pattern: childhood trauma plus PTSD showed the worst cannabis and psychiatric outcomes, trauma-only was intermediate, and no-trauma had the best outcomes.
Largest GWAS of cannabis initiation timing found 38% heritability and identified ATP2C2 (calcium signaling gene) as a candidate, linking cannabis initiation to the same pathway implicated in cocaine and opioid dependence.
MTA follow-up found adults with ADHD who persistently used substances perceived cannabis as improving both mood and ADHD symptoms, though broad substance-mood perceptions did not differ from non-ADHD users.
Study of 265 early psychosis patients found CUD was a significant violence risk factor, with two high-risk profiles: CUD + impulsivity, or CUD + lack of insight + non-adherence. Good insight and adherence moderated the risk.
Largest cannabis GWAS (184,765 people) found 8 significant variants, CADM2 as the top gene, 11% heritability, and Mendelian randomization evidence that schizophrenia risk causally increases cannabis use.
National database analysis found heart attack admissions among cannabis users rose 32% from 2010-2014, with in-hospital mortality up 60%, predominantly in males averaging age 41.
ADHD adolescents with cannabis use disorder had higher hospital costs, longer stays, and 17-fold higher alcohol abuse risk, but received 55% less psychiatric medication and 59% less behavioral therapy.
Study of 247 first-episode psychosis patients found cigarette smoking age, poor childhood academics/sociability, and trauma all predicted heavier premorbid marijuana use before psychosis onset.
Using incentive-based monitoring, 42% of cannabis-dependent schizophrenia patients achieved 28 days of verified abstinence - statistically similar to the 55% rate in non-psychiatric controls.
Analysis of 405 psychiatric outpatients identified four distinct profiles of co-occurring substance use and mental health symptoms, with cannabis use prominent in three of the four groups.
Ten-year study of 481 street-involved youth found daily cannabis users were 34% less likely to start injecting drugs, challenging the gateway drug hypothesis.
Among 829 hospitalized psychosis patients, those with both cannabis and tobacco use disorders had the highest rates of additional substance use problems, highlighting the need for comprehensive screening.
French university students with ADHD (5.6%) had significantly higher rates of cannabis, alcohol, and tobacco use plus behavioral addictions, and were more likely to struggle academically.
Residential crossover study found dronabinol (oral THC) at 120-240 mg/day significantly reduced cannabis self-administration in daily users, supporting agonist therapy as a potential treatment approach.
Rigorous abuse potential study found CBD showed very low drug-liking even at 6 times the therapeutic dose, and it was significantly lower than alprazolam and dronabinol on all abuse measures.
Meta-analysis of 69 studies found cannabis cognitive deficits are small (d=-0.25) and become non-significant after 72 hours of abstinence — meaning most impairment is residual drug effect, not lasting damage.
Alcohol-dependent animals had depleted endocannabinoid (2-AG) levels in the amygdala, linked to anxiety and excessive drinking. Drugs that boosted 2-AG reversed both effects.
Smartphone tracking found that 73.5% of young heavy cannabis users lapsed during attempted abstinence, with negative expectations, low family support, and permissive environments predicting relapse.
Large cohort study found daily cannabis users had 21% greater odds of staying in opioid treatment (methadone/buprenorphine) over nearly 7 years of follow-up.
Cochrane review of 8 trials found no clear differences between antipsychotics for dual diagnosis patients, though one small study suggested clozapine may reduce cannabis craving more than risperidone.
Pilot trial found nabiximols was safe and well-tolerated in cannabis-dependent patients, with 70.5% cannabis use reduction (vs 42.6% placebo) and reduced craving, though differences were not statistically significant.
Among 500 young smokers, marijuana users were equally motivated to quit tobacco but 44% less likely to succeed, suggesting co-use creates a specific barrier that cessation programs need to address.
Systematic review of 10 trials found dronabinol, nabilone, and nabiximols all show promise for treating cannabis withdrawal, with good safety profiles and potential dose-dependent effects.
Brain imaging found altered emotional processing circuits in marijuana users that persisted after 28+ days of abstinence, specifically during negative emotions, potentially explaining vulnerability to relapse.
Among 145 cannabis users, those perceiving more barriers to quitting had more use problems, worse withdrawal symptoms, and lower confidence in their ability to quit.
Brazilian national survey found cannabis users had three times the rate of suicidal ideation (31.5% vs 9.9%) and suicide attempts (16.5% vs 5.4%), persisting after controlling for depression.
Among 319 Iraq/Afghanistan veterans, cannabis dependence was associated with nearly 8-fold increased odds of post-deployment suicide attempts, independent of PTSD, depression, and other substance use.
A study of 5,452 cannabinoid prescription users in Manitoba found only 18% continued use at one year, with median duration of 31 days varying by diagnosis and medication type.
In a year-long study of 545 at-risk military personnel, marijuana use combined with high PTSD symptoms predicted worsening PTSD and increased suicidal behavior, an interaction not seen with alcohol or opioids.
Among 230 schizophrenia patients in Pakistan, ongoing cannabis use was linked to treatment resistance even after excluding non-adherent patients, with over 60% of the cohort being treatment-resistant.
Focus groups with 37 cannabis-using teens identified rewards, self-monitoring, peer support, privacy, and customizable notifications as key elements for an engaging cessation app.
A comprehensive review of THC covers its pharmacology as a CB1 partial agonist, approved uses for pain and nausea, and ongoing debates about psychosis risk, cognitive effects, and addiction potential in 192 million users worldwide.
A comprehensive review details how alcohol alters the endocannabinoid system to drive addiction, how CB1 receptors contribute to alcohol reward, and how ECS disruption contributes to fetal alcohol spectrum disorders.
A review distinguishes the endocannabinoid system's role in alcohol addiction (CB1 in reward circuits) from its role in fetal alcohol disorders (developmental ECS disruption), suggesting different therapeutic targets.
A systematic review found CBD improved schizophrenia symptoms (especially early-stage) and reduced cannabis withdrawal when combined with THC, with blood anandamide levels as a potential biomarker.
High-sensitivity testing found 25% of urban teens positive for THC, far more than standard tests detected. Cigarette smokers had 13x the odds of marijuana use.
An fMRI study found adolescent cannabis use disorder was linked to reduced brain activation in threat-processing regions including the amygdala, an effect not seen with alcohol use disorder.
A review of 40 studies found chronic cannabis use consistently increases cerebellar gray matter volume, alters resting brain activity, and impairs memory and decision-making.
A comprehensive neuroimaging review found cannabis affects executive, emotional, reward, and memory brain systems through direct and indirect pathways, with adolescent use carrying particular risk for lasting changes.
A survey of 1,321 chronic pain patients found 80% substituted cannabis for traditional pain meds, including 53% for opioids, citing fewer side effects and better symptom control.
A systematic review of 1,301 papers found only 27 qualifying studies of CBD for psychiatric disorders, with limited but promising signals for substance use, psychosis, and anxiety.
Cannabis use predicted suicidal ideation, planning, and attempts in 451 Latinx LGB teens, with the strongest association (OR 3.12) for actual suicide attempts.
A review found CBD reversed stimulant toxicity, reduced drug-seeking, and prevented relapse in animal models of cocaine and methamphetamine addiction, with observational human data showing reduced craving.
A study of 86,254 teens across 21 countries found cannabis use approximately doubled the odds of suicide attempts, with the association consistent across countries with widely varying cannabis prevalence.
A heavy cannabis user developed Wernicke's encephalopathy (brain damage from thiamine deficiency) after severe vomiting from cannabis hyperemesis, a complication usually associated with alcoholism.
Past-year marijuana use nearly doubled among former US cigarette smokers from 2002-2016, while depression and binge drinking also rose, threatening sustained smoking cessation.
Among 12,642 teens, bullies and bully-victims had higher marijuana use, but stronger parent and peer attachments significantly reduced this risk, suggesting targets for prevention programs.
A large multi-site study found only cannabis-dependent users, not regular non-dependent users, showed smaller hippocampi, regardless of dose, suggesting dependence involves unique brain changes.
Antipsychotic-naive psychosis patients with recent cannabis use showed more excitement symptoms initially but responded better to treatment at 10 weeks, suggesting a potentially more treatable psychosis subtype.
Cannabis-using youth showed weaker frontostriatal brain circuit activation during cognitive conflict tasks, suggesting self-regulation circuit changes appear early in the course of cannabis use.
Large veteran study found co-occurring opioid and cannabis use disorders linked to fewer opioid prescriptions but higher psychiatric admissions and homelessness compared to opioid use disorder alone.
Narrative review of animal studies showing CBD reduces alcohol consumption, motivation to drink, and relapse while protecting against alcohol-related liver and brain damage.
Genome-wide study of over 350,000 people identifies CHRNA2, a nicotinic receptor gene, as the first replicated genetic risk factor for cannabis use disorder, linking it to cholinergic and cognitive pathways.
Review exploring how combined alcohol and cannabis exposure alters gene activity through epigenetic mechanisms across different life stages, with potential for lasting and even intergenerational effects.
Five-year study of 7,717 opioid treatment patients found persistent heroin use strongly predicted crack cocaine co-use but was associated with less cannabis escalation, with crack being the key predictor of treatment failure.
Comprehensive review finding CBD has established efficacy for epilepsy, early clinical signals for anxiety and psychosis, and preclinical-only evidence for depression and Alzheimer's.
Longitudinal study of 4,975 young men found ADHD predicted persistent risky alcohol and nicotine use but was associated with maturing out of risky cannabis use over 15 months.
Female rats showed greater CB1 receptor changes than males after identical THC exposure across all brain regions. Estradiol contributed to the difference.
Study of 366 young LA cannabis users found self-reported medical use linked to less illicit drug use, while concentrate and edible use predicted more other drug use, regardless of frequency.
Study of 500 college students finds the MAOA gene interacts with childhood abuse to predict cannabis and tobacco use in sex-opposite patterns: high-activity variants matter in women, low-activity in men.
Review of cannabinoid-based addiction treatments finds promising newer strategies including neutral CB1 antagonists, CB2 agonists, and CBD after the rimonabant setback, with some entering clinical trials.
Twin study of 2,007 young adults finds non-medical painkiller misuse shares moderate genetic overlap with cannabis and nicotine use, but minimal overlap with cannabis or alcohol use disorders.
Mouse study reveals a peripheral CB1 blocker reduces alcohol drinking by suppressing active ghrelin production in the stomach, working through gut-to-brain vagal nerve signaling without entering the brain.
Clinical review for psychiatrists finds synthetic cannabinoids cause faster dependence, worse psychiatric symptoms, more dangerous withdrawal, and physical effects including seizures and death compared to natural cannabis.
Rat study shows the neutral CB1 antagonist AM4113 reduces heroin self-administration without the depression-like side effects that derailed rimonabant, pointing toward a safer cannabinoid-based opioid addiction treatment.
Controlled study shows varenicline doubled tobacco abstinence rates in cannabis co-users (46% vs 24%), while nabilone eased cannabis withdrawal, with tobacco-related variables predicting cannabis relapse.
Systematic review of 14 RCTs (1,629 participants) finds cannabis-based medicines improved symptoms across multiple mental disorders as adjuncts but achieved no remissions, with larger trials needed.
Small pilot study of guanfacine for cannabis withdrawal in 7 volunteers found no significant effects on withdrawal or craving, with trends toward improved mood that may warrant larger investigation.
Study of 1,661 Australian teens found 10% used multiple substances, with depression, conduct problems, and school environment as the strongest predictors, suggesting prevention should target mental health.
First US adolescent fMRI cannabis cue study shows 41 cannabis-using youth had heightened brain activation to cannabis images in reward and attention regions.
Substudy of 37 cannabis-using youth found approach avoidance training that reduced cannabis use in a larger trial did not significantly change brain cue reactivity on fMRI, with only trend-level effects.
Systematic review of CBD in psychiatry finds limited evidence for cannabis withdrawal, addiction, psychosis, and social anxiety, with few side effects.
Longitudinal study of 1,152 people with chronic pain found daily cannabis use associated with 50% lower odds of daily illicit opioid use.
Pilot RCT found simultaneous tobacco treatment during cannabis treatment was feasible and acceptable, but tobacco quit rates were low in both timing conditions.
The Newton screen demonstrated 93% sensitivity and specificity for cannabis use disorder in 4,898 adolescents across 16 pediatric emergency departments.
Survey of 93 veterans with free cannabis access found most used it to substitute for other substances, but chose high-THC products without clinical guidance.
Review finds limited support for cannabis benefits in mental illness, growing evidence of harm in psychosis and mood disorders, and proposes a framework for understanding addiction vulnerability.
Survey of 2,032 Canadian medical cannabis patients found 69% substituted for prescription drugs, with 59% of opioid substituters reporting complete cessation.
Cannabis-related psychiatric disorders tied with schizophrenia (31.6% each) as the leading reason for psychiatric hospitalization at a South African mental health unit.
Birth cohort study found cannabis use at 16 approximately doubled the odds of a first suicide attempt by 21 among adolescents with suicidal thoughts or self-harm.
Alcohol conditioning decreased endocannabinoid levels in mouse brain reward regions, and CB2 receptor blockade reduced alcohol's rewarding effects.
Survey of 1,140 college students found 7.9% used synthetic cannabinoids, driven by legality and drug test avoidance, with natural cannabis users at 7.6x higher odds.
Survey of 282 cannabis-tobacco co-users found high tobacco quit interest (7.1/10) but low cannabis quit interest (2.4/10), with bidirectional substitution during quit attempts.
The first cannabis receptor blocker worked for obesity and quitting smoking but caused depression and suicidal thoughts. Researchers are now developing safer alternatives.
Two longitudinal studies found that parental cannabis use was associated with higher rates of cannabis use in their children, from adolescence through young adulthood.
Cocaine users who also used cannabis heavily had worse cognitive performance and no reduction in relapse compared to cocaine-only users.
In 404 first-episode psychosis patients, tobacco, alcohol, and cannabis use each predicted worse treatment outcomes over two years, with tobacco linked to the most negative effects.
A Danish study of over 3 million people found that schizophrenia significantly increases the risk of subsequently developing substance abuse, with cannabis showing the highest risk.
Cannabis-using psychosis patients were more dissatisfied with medication and rehospitalized more, but long-acting injectable antipsychotics reduced this risk.
Cannabis users showed involuntary attentional capture by cannabis cues within 125-200 ms, along with more errors and poorer selective attention.
In young adult regular cannabis users, the strongest predictors of use disorder severity were use frequency, beliefs about cannabis impairing cognition, perceived cognitive deficits, and anxiety.
PET brain imaging found altered CB1 receptor binding across cannabis use disorder, alcohol use disorder, schizophrenia, PTSD, and eating disorders.
Rat study found THC enhances brain reward at low doses (CB1) but suppresses it at high doses (CB2) — a biological explanation for why more weed doesn't mean more fun.
Pilot trial found galantamine was safe in cannabis use disorder but showed no cognitive benefits beyond placebo over 10 days.
Cannabis-related compound delta-8-THCV reduced nicotine addiction across all seven rodent models tested, including self-administration, relapse, and withdrawal.
Latent class analysis of 329 weekly cannabis users found those with stronger use motives had more psychosis symptoms, depression, anxiety, and reckless behavior.
Study found opioid treatment patients living closer to cannabis outlets missed more methadone doses, while proximity to the treatment center improved adherence.
First meta-analysis of cannabis withdrawal prevalence: 47% of regular/dependent users experienced clinically significant withdrawal across 23 studies and 27,000+ participants.
Survey of 200 people found most who used cannabis for opioid withdrawal reported improvement, especially in anxiety, tremors, and sleep.
Adolescent rat offspring exposed to THC during fetal development showed impaired emotional memory, reduced neuropeptide Y neurons, and increased alcohol-seeking behavior, suggesting prenatal THC may create lasting vulnerability.
A mouse model of a human FAAH gene variant showed that adolescent females had enhanced dopamine reward circuitry and stronger THC preference that lasted into adulthood, while males were unaffected.
A review found CB1 neutral antagonists and FAAH inhibitors show the most promise among endocannabinoid-based approaches for tobacco addiction, after the CB1 inverse agonist rimonabant was withdrawn due to psychiatric side effects.
A study of 1,059 tobacco quitline callers in states with legal marijuana found 24% also used marijuana, with 43% of those users wanting to quit or reduce their marijuana consumption.
A review found preliminary evidence that cannabis may help PTSD patients and reduce use of more harmful drugs, but rigorous clinical trials are needed to establish whether cannabis-based medicines should be integrated into treatment.
An 8-week pilot trial found guanfacine extended-release was feasible for cannabis use disorder, with significant reductions in use amount and frequency, though only 41% remained in the study.
A nationwide VA study of 1,413 veterans found cannabis co-use was not associated with meaningful reductions in opioid use or PTSD symptoms, challenging policy rationales for cannabis as a PTSD treatment or opioid substitute.
Specific nicotinic receptor subtypes (alpha3beta4, alpha6beta4) modulated THC withdrawal in mice, with human genetic variants in the same genes associated with cannabis disorder, identifying new medication targets.
Rimonabant-precipitated THC withdrawal in mice significantly reduced motivation for sucrose rewards, modeling the anhedonia of human cannabis withdrawal. A CB1 positive allosteric modulator did not prevent this effect.
Among veterans with cannabis use disorder, 79% had a co-occurring mental health disorder and 77% had another substance use disorder, with comorbid conditions driving greater mental health service use.
Prospective study found 21% of first-episode schizophrenia patients had breakthrough psychosis despite long-acting antipsychotic injections, with cannabis use as an independent predictor.
Cross-sectional study of Canadian students found feeling connected (relatedness) and capable (competence) were linked to less cannabis and alcohol use, while autonomy was linked to more use.
Small retrospective study found 47% of first-episode mania patients who were screened tested positive for cannabis, higher than general population rates.
Longitudinal study of 301 young adult cannabis users found self-reported medical use was linked to lower illicit drug use, while concentrate and edible use was linked to higher drug use trajectories.
First 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.
National 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.
Rat 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.
Portuguese 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.
Survey 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.
Study comparing 201 cannabis-dependent patients to 285 controls found specific methylation differences at dopamine transporter gene sites bound by nervous system development transcription factors.
National 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.
Study 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.
Survey 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.
Umbrella 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.
Exploratory 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.
Case report of a patient in opioid treatment whose persistent fentanyl-positive tests were traced to fentanyl-contaminated street cannabis, resolving after switching sources.
Rat 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.
Mouse study found the CB2 agonist LY2828360 synergized with morphine for neuropathic pain relief while blocking morphine reward and partially reducing physical dependence.
Survey of 166 Iranian university students found that personal attitudes and perceived control, not peer pressure, were the strongest predictors of marijuana use intentions.
Largest GWAS meta-analysis of cannabis use disorder (384K participants) identified 22 risk loci, 11% SNP heritability, and strong genetic overlap with ADHD, depression, and schizophrenia.
Longitudinal study of 437 homeless adults in Vancouver found that co-occurring substance use and psychotic disorders were associated with the highest mortality risk over 10 years.
CB2 inverse agonist Xie2-64 reduced cocaine self-administration and relapse-like behavior in rats without affecting food motivation, suggesting a new approach to cocaine addiction treatment.
fMRI study of 54 young adults found that those at higher risk for cannabis use disorder showed stronger brain activation in reward regions when exposed to cannabis odor cues.
Review of 20 years of research found that alcohol produces its addictive brain effects and liver damage largely through the endocannabinoid system, particularly CB1 receptors.
Analysis of 7.3 million PCI patients found cannabis users had no worse in-hospital mortality, bleeding, or stroke, and had lower vascular complications compared to non-users.
Systematic review of 41 studies found cannabis use during opioid addiction treatment was mostly unrelated to opioid use, treatment adherence, or retention outcomes.
Meta-analysis of two nationwide studies found daily cannabis use associated with 60% higher odds of violence in people with psychotic disorders, though stimulant and depressant use carried higher risks.
Both CB1 blockade and CB2 activation independently reduced cocaine reward and sensitization in mice, both preventing hippocampal neuronal activation.
Survey of 973 regular drinkers among Canadian medical cannabis patients found 44% reduced drinking frequency and 8% stopped entirely after starting medical cannabis.
fMRI study found cannabis use disorder altered brain connectivity between emotion and stress circuits, with stronger amygdala-hypothalamus signaling correlated to perceived stress.
Study of 106 psychiatric inpatients found 25.5% used cannabis the week before admission, but psychotic diagnosis, not cannabis dose, was the main predictor of symptom severity.
Study of 1,206 young adults found that cannabis dependence, but not recreational use, was associated with a breakdown in normal brain separation between cognitive and emotional processing.
Among 938 young adults with first-episode psychosis, one-third had persistent cannabis use at 1 year with worse symptoms, while those who reduced use showed significant improvement.
Study of 47,447 screened primary care patients found daily cannabis use predicted 24% higher risk of emergency or hospital visits, while other drug use carried even stronger risk.
Survey of 4,078 Nigerian adolescents found friend drug use, parental smoking, low risk perception, and positive drug beliefs predicted cannabis and illicit drug use.
Prospective study of 265 early psychosis patients found starting cannabis before age 15 was associated with 4.5 times higher odds of violent behavior.
Review found CB1 receptor remains a promising obesity target despite rimonabant failure, with peripheral-only blockers and neutral antagonists as safer alternatives.
Meta-analysis of 50 studies (40,783 people) found 34% of cannabis-induced psychosis cases transitioned to schizophrenia, the highest rate among all substances.
Study of 99 cannabis treatment seekers found ADHD prevalence of 34-46%, far exceeding general population rates, suggesting routine ADHD screening should be standard.
Systematic review of 9 studies (7,222 patients) found 64-75% opioid dose reduction with medical cannabis for chronic pain, but all studies had high bias risk.
Study of 431 chronic pain patients found emotion dysregulation explained the link between cannabis use problems and anxiety, depression, and suicidal ideation.
Analysis of 27M pediatric hospitalizations found cannabis use disorder 68% more common in prescription opioid overdose cases, alongside high rates of mood disorders.
Study of 1M+ schizophrenia inpatients found cannabis use disorders independently associated with 38% higher medication non-compliance after adjustments.
Study of 1,008 adults found cannabis misuse predicted ADHD symptoms (hyperactive and inattentive) but not other cognitive deficits; age of first use showed no cognitive effects.
Prospective study of 2,327 college students found dual cigarette/e-cigarette use predicted marijuana vaping initiation, while vape shop social networks predicted escalation.
Thirteen-year study of people who inject drugs found daily cannabis use associated with 26% faster opioid injection cessation, with no increase in relapse risk.
Eleven-year study of 1,457 Hispanic youth found high school discrimination predicted marijuana use initiation and continuation into emerging adulthood.
Analysis of 709,658 drug-related healthcare visits in Florida found cannabis SUD was the lowest-cost condition, with opioids 23.4% and cocaine 9.25% more expensive.
Twelve-month study of 751 chronic pain patients found sustained improvements in pain, quality of life, and opioid dose reduction with medical cannabis.
PNAS study found adolescent cannabinoid exposure reprogrammed the rat brain response to cocaine at epigenomic, transcriptomic, and proteomic levels, specifically during adolescence.
Study of 852 adolescents found childhood cigarette/alcohol use and family factors in fifth grade predicted cannabis use patterns through age 19.
Study of 592 high-risk drug users found 75.7% substituted drugs, with 33.5% of cannabis users switching to synthetic cannabinoids and 35.9% of heroin users to street methadone.
Among 342 drug treatment patients, cannabis use was the strongest predictor of synthetic cannabinoid use (AOR 9.86), while gabapentinoids predicted prescription opioid use (AOR 14.33).
JAMA study found states listing OUD as a cannabis qualifying condition had 39% more dispensaries claiming cannabis treats OUD, potentially diverting patients from proven medications.
Study of 2,545 cannabis users found impulsivity and coping motives predicted heaviest use (daily, 4+ times), with 36% of users in the highest frequency group.
Molecular Psychiatry study found ADHD genetically causes 8-fold increased cannabis use risk (OR 7.9), with 29% genetic overlap and 4 new shared loci identified.
Survey of 525 chronic pain patients found 40% completely stopped opioids after starting medical cannabis, with 87% reporting improved quality of life.
A South African study found 55.6% of patients with psychotic disorders had co-occurring substance use disorders, with cannabis use disorder being the most common at 34.3%.
Among 601 adult smokers in San Francisco primary care clinics, over half also used cannabis, e-cigarettes, or both, but cessation counseling rarely addressed poly-use.
A secondary analysis of 302 adults in a cannabis cessation trial found that depression predicted less abstinence (especially in women) and that depressive symptoms preceded increased cannabis use, not the other way around.
AB-FUBINACA produced classic cannabinoid effects that cleared rapidly from the brain but still induced physical dependence after just 5 days of twice-daily dosing in mice.
A Bayesian meta-analysis found current interventions for tobacco-cannabis co-users showed weak evidence for cessation of either substance, though multi-substance approaches were more promising for cannabis.
US cigarette quit ratios from 2002-2016 remained dramatically lower for cannabis users (23%) and those with CUD (15%) compared to non-users (51%), with no improvement for CUD over 15 years.
Cannabis-dependent men showed worse cognitive performance under stress with reduced precuneus brain activity, despite experiencing similar levels of subjective stress as controls.
Genetic analysis of 11 psychiatric disorders found cannabis use disorder was significantly correlated only with ADHD, while alcohol and nicotine dependence showed broad genetic overlap with multiple psychiatric conditions.
A 20+ year comparison of methadone clinics found cannabis use at admission increased only in Las Vegas (legal cannabis) and predicted worse treatment retention in both Las Vegas and Tel Aviv.
CBD reduced the rewarding and anxiety-producing effects of the bath salt MDPV in mice, but unexpectedly increased drug-seeking in high-responding mice, revealing complex interactions.
A daily diary study of 97 young adults found that cannabis-related enhancement and social motives were the primary drivers of same-day alcohol and cannabis co-use, more so than alcohol-related motives.
Adverse event reports from recreational cannabis in France tripled between 2012 and 2017, reaching 2,217 cases. Psychiatric effects were most common (51%), and cannabinoid hyperemesis syndrome emerged as a new concern from 2015.
Among 446 methadone patients, frequent cannabis users were 71% less likely to report a nonfatal opioid overdose in the past year (3% vs 9%), though the cross-sectional design prevents causal conclusions.
Among 387 people who inject drugs, cannabis was commonly used for pain relief, emotional support, and as an opioid substitute. Using cannabis for pain was strongly linked to using it as an opioid replacement.
In 124 patients with schizophrenia in a high-security hospital, cannabis use disorder was not linked to violence or impulsivity. Alcohol use disorder was nearly four times more likely to be associated with violent behavior.
Retrospective study of 423 IBD patients found that preadmission cannabis use was associated with higher inpatient opioid doses, even after adjusting for disease severity and prior opioid use.
Analysis of 3,785 Australian twins found five drug use patterns, with persistent polydrug use showing 94% heritability and links to conduct and antisocial personality disorders.
Analysis of ED data from 29 states found recreational cannabis laws reduced opioid-related emergency visits by 7.6% for two quarters, with effects concentrated in men aged 25-44, but the reduction faded after six months.
Study of 2,051 European teens found endocannabinoid gene interactions (CNR1, MGLL, DAGLA) associated with alcohol use disorder risk, with partial replication in 772 Canadian adolescents.
Review showing 2-AG endocannabinoids gate dopamine value signals across reward, timing, and threat avoidance — explaining why cannabis broadly affects motivation.
Study of 863 Spanish adolescents found girls had higher mental health-substance use comorbidity, with depression predicting cannabis use disorder and obsessive-compulsive symptoms predicting alcohol use disorder.
Monthly surveys of 761 young adults found marijuana use peaked in April and December, while alcohol peaked in summer, October, and December, with patterns varying by college status.
Study of 1,108 college students found those who mixed prescription stimulants with alcohol or marijuana had the heaviest substance use, most consequences, and used marijuana to alter other drug effects.
Study of 5,792 high schoolers found earlier substance use predicted emotional detachment from parents, which in turn predicted progression to illicit drugs like cocaine and hallucinogens.
Analysis of 71,870 Oregon 11th graders found counties with the most marijuana and alcohol retail outlets had significant increases in adolescent co-use after legalization, mediated by changes in beliefs about availability and risk.
CBD reversed behavioral symptoms and molecular brain changes during spontaneous cocaine withdrawal in mice, normalizing dopamine and cannabinoid receptor gene expression.
Survey of nearly 3,000 Czech and Slovak university students found tobacco and cannabis use both correlated with alcohol use disorders, with males at higher risk, during early COVID-19.
Adolescent cannabinoid exposure in mice reduced cocaine reward in adulthood and increased a DNA methylation enzyme in the prefrontal cortex, without affecting anxiety or depression.
Study of 284 first-episode psychosis patients found tobacco-only users had a distinct clinical profile, while adding cannabis was linked to 2.5 years earlier onset and more hallucinations and disorganized thinking.
Daily tracking of 211 adults found opioid use was twice as likely on days they also used cannabis, regardless of pain, contradicting the cannabis-as-opioid-substitute hypothesis.
Review found cannabis smoking causes bronchitis and increases airway resistance but does not clearly cause COPD, emphysema, or lung cancer, a pattern distinctly different from tobacco.
Rat study found chronic morphine significantly increased CB2 cannabinoid receptor expression on spinal neurons, more than nerve injury alone, suggesting a mechanism for opioid-cannabinoid treatment synergy.
Review found THC may increase heart attack risk through sympathetic activation and vascular dysfunction, while CBD shows preclinical cardioprotective effects, creating a complex risk profile.
Analysis of 281,650 young adults found cannabis use disorder was associated with higher suicidality regardless of depression, with women showing significantly stronger associations than men.
Genomic analysis found significant genetic overlap between cannabis use disorder vulnerability and COVID-19 hospitalization risk, independent of tobacco, alcohol, or respiratory disease genetics.
Multicenter RCT of 169 people with alcohol or cannabis use disorder found that internet-based attentional bias training added to standard treatment produced no improvements in any outcome over 12 months.
National survey of 4,069 veterans found 11.9% cannabis use overall, rising to 24-30% among those with psychiatric conditions, with depression independently tripling CUD risk.
Study of 4,069 veterans found cannabis use disorder was more strongly associated with suicidal ideation and planning than alcohol use disorder alone, independent of psychiatric and trauma factors.
Study of 3,157 veterans found cannabis use and cannabis use disorder were associated with 1.5 to 8.3 times higher odds of psychiatric conditions, suicidality, and treatment utilization.
Study of 88,637 individuals found genetic risk for schizophrenia did not predict cannabis use disorder, while genetic risk for ADHD did, challenging the shared-genetics hypothesis for the cannabis-schizophrenia link.
Large genetic study found cannabis use disorder (but not simply trying cannabis) was robustly associated with schizophrenia risk after controlling for tobacco, with mixed evidence on whether the relationship is causal.
National study found emerging adults, men, Black/African American, Native, and sexual minority groups had the highest risk of co-occurring cannabis use disorder and suicidality.
Review of 37 studies found men are twice as likely to have CUD overall, but certain mental illnesses (anxiety, antisocial personality) reverse or narrow the sex gap.
Case report of a teenager with multiple substance addictions and depression who improved across all domains after switching from antidepressants to CBD, including quitting all illegal drugs.
Review of how endocannabinoids and dopamine work as partners across Maslow's hierarchy — from survival drives to achievement — and how cannabis disrupts that partnership.
Mouse study found CBD prevented cocaine relapse, abolished cocaine hyperactivity, and improved withdrawal memory deficits without producing reward itself.
A validation study of 517 adolescents found the S2BI screening tool accurately identified moderate-to-severe cannabis use disorder (90% sensitivity, 89% specificity) but was less reliable for mild cases.
A MEG study of 45 adults who used both alcohol and cannabis found that alcohol use disorder was associated with blunted occipital alpha brain wave responses, with no independent effect from cannabis use disorder.
A 10-year case series found 34 adolescents with cannabis hyperemesis syndrome at one institution, with clinical features matching adult presentations and no antiemetic proving consistently effective.
A chart review of 50 ADHD patients found heavy cannabis use was associated with significantly worse cognitive test performance, more fine motor hyperactivity, and higher self-reported impulsivity compared to ADHD patients without substance use.
A nationwide VA study of 1.2+ million patients found cannabis use independently associated with 2.65 times the odds of premature cardiovascular disease, with greater risk in women and polysubstance users.
A study of 5,987 young Swiss men found four distinct cannabis use disorder trajectories from ages 20-25, with mental health problems and peer drug use predicting who remained stuck at high severity.
Among 239 ADHD patients with substance use disorders, those seeking cannabis treatment had more anxiety, earlier substance use onset, and similar ADHD severity compared to those seeking cocaine treatment.
An Australian cohort study spanning 16 years found persistent cannabis, tobacco, and binge drinking from adolescence through young adulthood predicted gambling problems in the early 30s.
A schizophrenia patient hospitalized 30 times in 8 years reported significantly less need for illegal cannabis and no further hospitalizations after switching to low-THC CBD cigarettes.
About 25% of marginalized drug users in Vancouver reported using cannabis to reduce harm from other substances, most commonly as a substitute for stimulants and opioids.
A large genetic study found significant positive correlations between anorexia nervosa and both cannabis initiation and cannabis use disorder, with substance-specific patterns suggesting complex shared biology.
A study of 2,335 opioid use disorder patients found that current cannabis use was associated with 41% higher odds of suicidal ideation, adding complexity to the cannabis-for-opioid-harm-reduction narrative.
Interviews with 97 cannabis users in Nigeria found that abstinence-only recovery frameworks led to feelings of failure after relapse, prompting some to redefine recovery as a process of reduced use and improved well-being.
A 30-day daily diary study found sexual minority young adult smokers had 2-3 times the odds of same-day cigarette-cannabis and triple substance use compared to heterosexual peers.
Systematic review finds FAAH plays a role in alcohol use disorder biology, with inhibition reducing withdrawal symptoms but potentially increasing alcohol preference.
Meta-analysis of 8 national surveys finds cannabis use disorder is associated with 3x higher odds of major depression and generalized anxiety disorder.
Study finds cannabis users show elevated neurological soft signs regardless of psychosis status, suggesting cannabinoids affect brain circuits involved in motor and sensory processing.
National analysis of 68 million hospital records finds cannabis use disorder associated with 28-52% higher odds of arrhythmia hospitalization in young adults, with atrial fibrillation most common.
Study across 6 Canadian managed alcohol programs finds 63% of participants already substitute cannabis for alcohol, with 84% willing to join a formal substitution program.
Cannabis activates the same dopamine reward pathway as all drugs of abuse. The endocannabinoid system's role in modulating these signals may offer new targets for treating addiction broadly.
Study of 307 inpatients finds cannabis-induced psychosis differs from schizophrenia with fewer negative symptoms and more mania, with cannabis use linked to nearly a decade earlier first hospitalization.
Prospective study finds cannabis-using psychosis patients have higher dissociation and worsening functioning over 8 months, while non-users improve.
Study of 62 FEP patients finds cannabis use and treatment delay independently contribute to dissociative symptoms, though cannabis does not extend the untreated period itself.
Study of 2,315 OUD patients finds overall cannabis use doesn't affect treatment outcomes, but daily cannabis use is associated with 39% lower odds of continued opioid use.
Study found patients with cannabinoid hyperemesis syndrome consumed more healthcare resources than non-users, driven by repeated evaluations before correct diagnosis, though cost differences were not consistently statistically significant.
Systematic review of 18 fMRI studies found regular cannabis users show consistently heightened brain activity in reward, executive control, and memory regions when exposed to cannabis cues, with preliminary links to craving.
Umbrella review found that while many risk factors for substance use disorders were statistically significant, only antisocial behavior had convincing evidence for predicting cannabis use disorder (OR=3.34).
Study found adults with ADHD show different clinical profiles based on substance type: cannabis users had worse general psychopathology, while stimulant/alcohol users showed more hyperactivity and legal problems.
PET imaging found women with cannabis use disorder had lower CB1 receptor levels in key brain regions than non-users, while healthy women naturally had higher CB1 levels than healthy men.
Prospective study of 361 veterans found sleep problems drove ADHD-related cannabis use, while using cannabis to cope with negative emotions predicted cannabis-related problems.
Study of 124 toxicology patients found 69% of new psychoactive substance cases involved synthetic cannabinoids, with most users primarily seeking to get high rather than avoiding drug tests.
Mendelian randomization found causal pathways from ADHD liability to smoking and cannabis initiation, but not convincingly in reverse, suggesting ADHD drives substance use rather than vice versa.
Genetic analysis of 989 ADHD patients and population GWAS data confirmed shared genetic architecture between ADHD and substance use disorders, with evidence ADHD causally increases SUD risk.
A 22-year-old with cannabinoid hyperemesis syndrome died after vomiting-induced hypokalemia triggered a fatal cardiac arrhythmia, complicated by QT-prolonging medications and cardiac genetic mutations.
Prospective study found CHS in 1.6% of patients with unexplained abdominal pain at two French EDs. CHS patients spent 70% more time in the ED and visited nearly twice as often.
Large longitudinal study of 4,535 cigarette smokers found no evidence that cannabis use inhibits quitting cigarettes, with similar quit rates across never, former, and current cannabis users.
Study of 301 cannabis-using young adults found those most influenced by legalization attitudes reported the heaviest use and highest problematic cannabis use scores.
Analysis of 10,644 adolescent drug users found two-thirds started with marijuana, with a 40% probability of transitioning to other drugs by year 8, lower than the 70-80% rate for those starting with other substances.
Web-based cannabis reduction program reduced use by 11.5 days/month in adults with ADHD symptoms, with significant improvements in depression, anxiety, and ADHD symptom severity at 3 months.
CHS emergency visits in Alberta doubled after legalization and rose further during COVID-19 (15 to 32 per 100,000). All surveyed CHS patients met criteria for cannabis use disorder.
GRADE-based clinical guidelines found no evidence to recommend any specific antipsychotic for schizophrenia patients with cannabis use disorder, highlighting a critical evidence gap.
Study of 215 Israeli combat veterans found moral injury was linked to cannabis use disorder through depression, with social support unexpectedly failing to protect against this pathway.
Among Israeli combat veterans, depression (AOR 1.98) but not PTSD independently predicted cannabis dependence, challenging assumptions about PTSD-driven cannabis use in military populations.
A survey of 3,805 Italian students found cannabis use at ages 14-15 was associated with a 26-fold higher likelihood of using new psychoactive substances.
In a 3-year follow-up of first-episode schizophrenia patients, 93.2% of those who relapsed used cannabis, compared to 56.7% of those who stayed in remission.
Substance users and addiction experts agreed that cannabis is less harmful than alcohol or benzodiazepines, but users rated cannabis benefits significantly higher than experts did.
A one-year study of 339 young adult cannabis users found childhood trauma led to problematic use primarily through using cannabis to cope with distress, while sleep-motivated use was not associated with problems.
A study of 926 boys identified six substance use trajectories through adolescence, with impulsive sensation-seekers at highest risk for early-onset polysubstance use including marijuana.
Most systematic reviews on cannabis use disorder treatments had authors with conflicts of interest (78%), but no significant relationship was found between COIs and biased results.
A systematic review of 22 cohort studies found no consensus on whether cannabis causes suicidal behavior, though heavier or earlier use may increase risk.
A study of 515 men found cannabis-dependent individuals had distinct personality profiles and a different frequency of the DRD2 rs1799732 dopamine receptor gene variant.
Among substance use disorder patients, women with ADHD started cannabis use earlier and used longer than any other group, highlighting a gender-specific vulnerability.
Cannabis withdrawal occurs in half of regular users, starting 24-48 hours after quitting and peaking within a week. No approved medications exist, but supportive counseling is first-line treatment.
A survey of 284 frequent synthetic cannabinoid users found worse withdrawal, faster tolerance, and harder dose control compared to high-potency natural cannabis.
A clinical guideline recommends atomoxetine for ADHD symptoms in patients with cannabis use disorder but finds it does not reduce cannabis use. Both atomoxetine and stimulants are considered safe in SUD patients.
A study of 2,945 young adults found racial/ethnic minorities experienced worse health, academic, and life satisfaction outcomes at the same levels of alcohol and cannabis use as White peers.
Among 539 university students, impulsiveness explained the link between problematic cannabis use and suicidal behavior, while childhood trauma amplified the cannabis-suicide attempt connection.
Longitudinal research links prenatal cannabis exposure to lasting effects on behavior, memory, and substance use from childhood through adulthood.
Pregnant women with any cannabis use history were 6 to 11 times more likely to smoke cigarettes during pregnancy and postpartum.
A neuroscience-based school program for older teens reduced binge drinking, cannabis use, MDMA use, and nicotine use at 6 months.
Nationwide data showed young adults with cannabis use disorder had higher rates of hypertensive crisis and worse cardiovascular outcomes during hospitalization.
NHANES data from over 21,000 adults linked past-30-day cannabis use to 54% higher odds of suicidal ideation and 53% higher odds of depression.
Social networks influenced how often young adults used cannabis, with stronger effects for recreational than medicinal users, but no link to problematic use.
Nearly half of young adult cannabis users mixed tobacco with cannabis, and more frequent mixing was associated with greater nicotine dependence.
Review and computational model suggest chronic cannabis use impairs the cerebellum's ability to process sensory errors, explaining observed motor learning deficits.
Longitudinal study tracked how young adults' cannabis use and medical patient status shifted after California legalized recreational use.
RCT found motivational interviewing reduced alcohol use equally well in Hispanic and non-Hispanic adolescents, with indirect effects on cannabis use through motivation.
25 years of Swedish workplace drug testing showed positive results quadrupling from 1.3% to 5.6%, with cannabis becoming the most detected substance after 2007.
A randomized trial found Housing First reduced alcohol and cannabis use among homeless individuals at 21 months, with additional mental health benefits for those with severe mental illness.
Study validated the DSM-5 cannabis use disorder diagnosis and severity levels, with severe CUD showing the strongest associations with psychiatric and social impairment.
Survey of 1,230 veterans found those who co-used tobacco and cannabis had significantly higher stress, PTSD, depression, and anxiety than single-substance users.
Nationally representative Canadian data showed young adults with ADHD had 46% higher odds of cannabis use disorder and 69% higher odds of any substance use disorder.
German hospital data showed a 4.8-fold increase in cannabinoid-related psychiatric admissions from 2000-2018, while alcohol and schizophrenia admissions remained stable or declined.
A neutral CB1 antagonist reduced cocaine-seeking behavior and relapse in rodents through dopamine pathways without the side effects seen with rimonabant.
Converging evidence from animal models and human studies suggests CB2 cannabinoid receptors play an important role in alcohol addiction biology.
Birth cohort study found prenatal opioid exposure doubled ADHD risk, with cannabis and alcohol interactions increasing risk further.
Pilot study showed CBT for insomnia resolved sleep problems in cannabis users, with 80% reducing cannabis use at 3 months and sustained improvements in mood.
Canadian survey during COVID-19 found increased cannabis use was associated with nearly twice the odds of suicidal ideation, alongside social isolation and depression.
Boosting either major endocannabinoid (anandamide or 2-AG) disrupted habitual behavior formation in mice, suggesting potential for preventing compulsive drug seeking.
Among 265 first-treatment psychosis patients, cannabis use was not linked to negative beliefs about antipsychotic medications despite predicting poor adherence.
In 15 daily cannabis smokers, the COX-2 inhibitor celecoxib did not reduce withdrawal symptoms or change endocannabinoid levels, and it increased cannabis craving.
Employers face conflicting laws and unreliable drug tests — a practical framework for cannabis workplace policies addresses safety, legal protections, and impairment measurement.
People with ADHD may use cannabis to manage self-regulation deficits, but evidence for therapeutic benefit is limited and the risk of problematic use is elevated.
Among 608 US veterans with PTSD, frequent cannabis users were 3-4x more likely to have depression, anxiety, and suicidal ideation, and 8-12x more likely to rely on avoidance coping.
Analysis of 1,174 young adults found five distinct cannabis use disorder profiles with different patterns of consumption, control, and withdrawal symptoms.
Among 910 young Canadian adults who drive after cannabis use, four distinct profiles emerged, from well-adjusted youth to those with generalized risky behavior and high distress.
Animal studies consistently show prenatal cannabis/THC exposure causes cognitive, emotional, and drug sensitivity changes in offspring, supporting their classification as developmental toxicants.
Among 3.3 million cannabis hospitalizations, pulmonary circulation disorders increased 200% over 7 years, with patients facing 2x the in-hospital mortality risk.
Among 4,270 French students, ADHD symptoms predicted continued cannabis use after one year but did not drive new cannabis initiation.
National data from 2011-2017 found marijuana associated with teen suicidal ideation and attempts at rates comparable to tobacco and alcohol, with a dose-response pattern.
In Lebanon, cannabis use disorder nearly tripled the odds of needing intensive psychiatric outreach for psychosis, alongside other severity markers.
Among 835 high schoolers, buying cannabis from someone or using a medical card at a dispensary predicted continued and more frequent use six months later.
Only 16 controlled studies exist for CBD in psychiatric disorders. Most promising evidence for psychosis and anxiety, but not enough for clinical recommendations in any condition.
Among 1,527 people who use illicit opioids in Vancouver, 22% intentionally used other substances to reduce opioid use, with cannabis being the second most common substitute at 28%.
In 246 first-episode psychosis patients, 78% had used cannabis, with 94% starting use years before psychotic symptoms. Earlier exposure predicted worse outcomes.
Young adults who newly adopted an LGBQ+ identity had 2.9x the risk of starting cannabis use, suggesting identity transition is a vulnerable period.
Following 701 people from age 10 to 22, high social anxiety trajectories predicted adult cannabis use (but not alcohol) along with dramatically elevated mental health disorder risk.
CBD has multiple properties relevant to opioid withdrawal management and is safe with opioids, but large clinical trials are needed before it can be recommended as an adjunct treatment.
A three-year follow-up of 1,689 adolescents found that even low-level alcohol use in the emergency department predicted nearly double the odds of developing cannabis use disorder.
Longitudinal brain imaging of 724 adolescents found combined alcohol and cannabis use accelerated gray matter decline in five brain regions, with neither substance alone producing the same effect.
Study of 667 schizophrenia patients found very high non-right-handedness (42.4%), which was associated with cannabis use disorder and learning disabilities, suggesting shared neurodevelopmental origins.
A digital therapeutic app delivering behavioral therapy and contingency management more than doubled 12-week abstinence rates for alcohol, cannabis, cocaine, and stimulant use disorders compared to treatment-as-usual.
Review of 41 studies found cannabis was the most commonly abused substance in dual diagnosis patients with psychosis, and aripiprazole was the most studied second-generation antipsychotic treatment.
Cannabis dependence roughly doubled or tripled across Argentina, Chile, and Uruguay from 2006-2018, while fewer than 16% of dependent individuals accessed treatment in any country.
Analysis of Reddit forums found people in opioid recovery use cannabis primarily for withdrawal management, while active opioid users use it to enhance the high, revealing two distinct patterns.
A 45-year cohort study found long-term cannabis users lost 5.5 IQ points from childhood, had poorer learning and processing speed, and smaller hippocampi by midlife, specific to cannabis over other substances.
Longitudinal study of 361 veterans found cannabis use predicted worsening PTSD intrusion symptoms at 6 months, while PTSD predicted cannabis use disorder at 12 months, suggesting a harmful cycle.
In young adult binge drinkers with insomnia, cannabis use during CBT-I treatment did not reduce therapy effectiveness, with virtually zero moderation effect on outcomes.
Survey of 905 Australian medical cannabis users found 32% met criteria for cannabis use disorder, with inhaled use, mental health indications, and frequent use as key risk factors.
Analysis of a CUD treatment trial found counseling attendance was the strongest predictor of abstinence, while nabiximols reduced dropout and improved engagement, supporting combined treatment.
Review of 370 South African psychiatric inpatient records found nearly half (48.9%) used cannabis, with use strongly linked to male sex, alcohol co-use, and more frequent hospital readmissions.
In a cannabis dependence trial, depression, anxiety, insomnia, and pain all improved over 12 weeks regardless of medication type, and even without complete abstinence from cannabis.
CBD reduced anxiety, agitation, and physical withdrawal symptoms in heroin-dependent mice while normalizing gene expression changes in brain reward regions.
Among 874 methadone patients in Nairobi, 85.8% tested positive for cannabis at baseline and 62.7% during follow-up, with widespread polysubstance use.
In a smoking cessation program, reductions in cigarette, e-cigarette, and cigar use were all associated with reductions in cannabis use over 3 months.
Italian pain clinic data showed opioid non-users rose from 32% to 55% after long-term cannabis oil therapy. No changes seen in other pain medication classes.
Among 251 pregnant women with opioid or alcohol problems, 43-53% also used marijuana. Younger age and polysubstance use were the strongest predictors of co-use.
Analysis of 3.3 million California students found marijuana legalization increased alcohol-cannabis co-use by 6% overall and 58% among past-month drinkers.
Machine learning predicted continued cannabis use in psychosis patients with 73% accuracy using clinical interviews alone. Lower functioning and lack of coping strategies were key predictors.
Survey of 2,183 Florida medical cannabis patients found 79% reported reducing or stopping pain medications after starting cannabis, with improvements in pain and physical functioning.
JAMA Psychiatry study found bipolar II and cannabis use disorder cluster in families. Mood episodes typically preceded CUD, suggesting shared vulnerability and a potential prevention target.
Adding a self-regulation-focused Grit program to residential substance treatment produced larger reductions in cannabis and methamphetamine use in young adults, sustained at 12 months.
Systematic review of 6 studies found contingency management effectively reduced cannabis use and achieved abstinence periods in people with psychotic disorders or major depression.
Longitudinal study of 1,084 young adults found 27% increased marijuana use during early COVID-19. Childhood adversity predicted increases among those with low resilience.
Analysis of 225 participants found reducing cannabis use to lower risk levels was associated with less anxiety, depression, and cannabis-related problems.
Study of 1,023 young adults found perceived parental approval of marijuana and heavy drinking was the strongest predictor of simultaneous alcohol-marijuana use.
Survey of 697 medical cannabis patients found 39.3% also used nicotine, with nicotine delivery method predicting cannabis consumption method.
ABCD study of ~12,000 children found 1.1% reported cannabis use by ages 12-13, with externalizing behaviors and parental drug problems predicting earlier substance initiation.
Mouse study found delta-8-THC produces tolerance, physical dependence, and abuse-like effects qualitatively similar to delta-9-THC, challenging "milder alternative" marketing.
Study of 877 methadone patients found cannabis use shortened treatment retention by 3 years, but this effect was absent in patients with schizophrenia.
Systematic review of 8 RCTs found nabiximols, CBD, and PF-04457845 outperformed dronabinol and nabilone for cannabis use disorder, covering more treatment outcomes.
Controlled trial of 28 young adults found cannabis mainly affects mood and subjective experience while alcohol primarily impairs cognition and motor performance. Combined effects were additive at most.
Pilot trial of 52 young adults found emotion-focused therapy outperformed standard CBT for reducing emotional distress in cannabis use disorder, with both treatments reducing cannabis use.
Study of 451 Latinx college students found attachment style, marianismo beliefs, and bicultural self-efficacy shaped the link between childhood adversity and substance use among women.
Among 23,091 medical cannabis patients in Ontario, cannabis poisoning ER visits occurred at 8 per 10,000 person-years and mental health crises at 15 per 10,000, with prior substance use being the strongest predictor.
Medical cannabis patients in Ontario had 2.45x the risk of drug poisoning ER visits and 2.27x the risk of substance-related mental health ER visits compared to matched controls.
Rats exposed to combined alcohol, cannabinoid, and nicotine during adolescence showed lasting learning deficits in adulthood, with females affected earlier than males.
Study of 47 college students found cannabis users were more likely to choose harder tasks for rewards, contradicting the "amotivational syndrome" hypothesis.
Saskatchewan pandemic survey found suicidal ideation was highest (25.8%) among those with both cannabis and alcohol problems, with younger adults and LGBTQIA2S+ individuals at elevated risk.
Review of 9 studies found recreational cannabis legalization increased cannabis use disorder prevalence but treatment admissions declined, suggesting a growing treatment gap.
Experiment with 700+ participants found that inducing negative mood increased self-reported cannabis problems and negative expectancies, even though actual use did not change.
Study found clinical psychosis risk youth had elevated cannabis, alcohol, and tobacco use, while genetically at-risk youth (22qDel) had lower rates, with social and cognitive factors explaining the difference.
Among 611 substance use inpatients, cannabis use disorder was the strongest predictor of 3-month relapse (53.3% rate, OR=2.31) in patients with co-occurring psychiatric disorders.
Review found CBD therapeutic effects emerge at 300+ mg/day, with best evidence for anxiety and addiction. Most OTC products fall below this threshold.
Study of 133 veterans found cannabis use and perceived value reinforced each other over 6 months, with use driving demand more strongly than demand driving use.
Patient on buprenorphine treatment presented with psychiatric symptoms from K2 use, but standard drug screens missed the synthetic cannabinoids and cathinones, requiring advanced GC-MS testing.
Researchers and heavy drinkers co-created cannabis education resources for managed alcohol programs, establishing standard cannabis units and drawing on lived experience for harm reduction guidance.
New Zealand survey of 11,405 teens found regular cannabis use stable despite declining lifetime use, with 24% of users vaping and highest rates among Maori, LGBTQ+, and disadvantaged youth.
Study found standard DSM-5 criteria flagged 30% of medical cannabis patients for cannabis use disorder, but adjusted scoring accounting for therapeutic use dropped the rate to 2%.
Analysis of 14,087 Australians entering drug treatment found cannabis was the primary concern for 15%, with high rates of poor mental health and polysubstance use across all groups.
National US data found pregnant and postpartum women with mental health disorders had 2-12 times higher odds of cannabis use disorder, with 9.8% overall cannabis use prevalence.
Genetic analysis found cannabis use disorder may reduce education by 1.2 months, while higher education was associated with more lifetime cannabis use but 61% lower disorder risk.
Pilot telehealth intervention promoting cannabis-free activities for untreated CUD achieved 70% completion with preliminary reductions in use, depression, and anxiety.
Study of 2,055 CUD patients found three treatment profiles, with 80% of high-adherence patients relapse-free at 2 years versus 24% in the moderate group.
Five-year Italian DUI study found 55% of cannabis-positive drivers only had inactive metabolites in blood — delayed testing couldn't confirm recent use or impairment at time of driving.
Among 125 addiction treatment inpatients using medical cannabis, 28% of medical-only users and 51% of dual-use patients met criteria for cannabis use disorder, with very high psychiatric comorbidity.
A review of purified CBD clinical trials found the strongest evidence for anxiety (17 RCTs), psychosis (8 RCTs), PTSD (4 RCTs), and substance abuse (3 RCTs), but not for pain or sleep.
Narrative review proposes adolescent CUD develops through feedback loops between drug characteristics, individual mindset, and environmental setting.
15-year study of 455 CVS adults: only 19% fully recovered, with cannabis use predicting 64% lower resolution odds.
National data showed weekly+ cannabis use was a stronger marker of social anxiety severity and suicide risk than formal cannabis use disorder diagnosis.
Scoping review found no proven intervention for reducing cannabis use in young adults with psychosis, though MI, CBT, and family training show minimal evidence.
Review of 22 RCTs found no approved cannabis craving treatment, but THC+lofexidine, oxytocin, progesterone, and NAC show promise.
15-year Swedish study of 12,143 CUD patients found 23% readmission rate, with schizophrenia (54% higher), low education (40% higher), and ages 18-35 as top risk factors.
A Swedish registry study of 3.3 million people found CUD diagnoses rising in younger cohorts, with 80% psychiatric comorbidity and distinct gender-linked subgroups.
Among 205 people using opioids in Vancouver, 58% used cannabis to manage cravings, and this was linked to self-reported reductions in opioid use.
Among 167,095 ICU pneumonia patients, alcohol misuse increased mortality while cannabis misuse showed no independent association after statistical adjustment.
Mini-review of 12 studies found suggestive evidence that cannabis use increases suicide risk in schizophrenia, particularly among men and during first-episode psychosis.
In female rats, high-CBD cannabis vapor reduced opioid reward and fentanyl self-administration with no abuse potential and a robust safety profile.
Registry data from all three Scandinavian countries showed cannabis-induced psychosis doubled while alcohol-induced psychosis declined from 2000 to 2016.
Among 352 Colombian adolescents, cannabis and tranquilizer use were independently linked to suicidal behavior alongside depression, aggression, and borderline traits.
After legalization, 4.7% of Canadian cannabis users showed impaired control, with higher risk among young males, early initiators, and those with mental health conditions.
Adolescent THC edible experience in rats enhanced alcohol's stimulant effects and altered frontal cortex endocannabinoid levels during alcohol withdrawal.
Veterans who stopped opioid use were more likely to also stop cannabis and cocaine, and reported improvements in pain and anxiety.
Among 441 cannabis users, paranoid and dysphoric intoxication experiences were the strongest predictors of motivation to quit, more than psychosis-like hallucinations.
In 249 first-episode psychosis patients, polygenic risk scores for cannabis use predicted symptom trajectories, suggesting partially independent genetic factors for initiation vs. disorder.
Among 713,290 bariatric surgery patients, cannabis use disorder was linked to 2.24x higher complication risk and 1.3 days longer hospital stays.
Umbrella review of 25 systematic reviews found consistent evidence linking recreational cannabis to suicidal ideation and attempts, with dose-response patterns.
Pilot study found adults with cannabis use disorder had blunted pleasure responses that personalized scripted imagery could partially restore.
Study validated the DSM-5 craving criterion across cannabis and 5 other substances, finding moderate craving was more predictive of clinical outcomes than severe.
Adding EMA to counseling increased mindful awareness in young cannabis users, and higher mindfulness was linked to lower cannabis desire and negative affect.
Rat study found CBD prevented the negative emotional conditioning associated with opioid withdrawal through 5-HT1A serotonin receptor activation.
Retrospective study of 68 chronic pain patients found a small reduction in opioid prescriptions after starting medical cannabis, with no changes in other healthcare use.
Machine learning and traditional models achieved only modest accuracy predicting cannabis use disorder treatment response in a multi-site trial analysis.
A 12-week group therapy program combining CBT and motivational enhancement reduced cannabis use, cravings, withdrawal, depression, and anxiety in treatment-seeking patients.
Study of 323 cannabis use disorder patients found most had pre-existing adverse childhood experiences, social-emotional impairments, or neurodevelopmental conditions.
Proof-of-concept RCT compared cannabis alone, oxycodone alone, and cannabis+oxycodone for fibromyalgia pain to test opioid-sparing potential.
Cross-sectional study of 153 substance-dependent patients in North India found ADHD prevalent across substance types including cannabis dependence.
Analysis of a CUD clinical trial found high-dose nabiximols did not cause clinically significant changes in biological markers including liver function.
Observational study found medical cannabis associated with changes in controlled substance prescriptions, including opioid-sparing effects and sedative hypnotic pattern changes.
Longitudinal study found continued cannabis use predicted worse outcomes in first-episode psychosis, with early intervention services only partially offsetting the disadvantage.
Scoping review of human lab cannabis self-administration studies identifies factors influencing consumption and highlights potential for testing CUD medications.
Study found tobacco dependence worsened cannabis withdrawal symptoms in both people with and without schizophrenia-spectrum disorders.
Survey of 14,897 Canadian adults found concurrent mental health problems and problematic substance use common during COVID-19, with identifiable risk factors.
Rural Maryland ER data linked cannabis use disorder to 2.7x higher odds of suicidal ideation, though depression and other substance disorders carried stronger associations.
Cannabis-nicotine co-users showed exaggerated blood pressure stress responses and higher cannabis cravings during nicotine withdrawal compared to single-substance users.
Review of clinical trials found CB1 receptor agonists like nabilone are the most promising medications for treating cannabis use disorder, though none are yet approved.
Two-year Brazilian study found cannabis use associated with 75% higher loneliness risk, the largest effect among clinical factors studied, though the direction of causation is unclear.
Study of 466 young Black and Latinx sexual minority men found cannabis used by 76%, with polysubstance use linked to higher HIV risk behaviors.
Canadian study of 60,000 adults found cannabis use disorder linked to 57% higher risk of cardiovascular events, with stronger relative risk in otherwise healthy individuals.
Study of 401 Black adults found cannabis-opioid co-use linked to worse mental health and opioid dependence but not worse pain, challenging assumptions about cannabis as an opioid complement.
Trial found methadone patients had 53% lower odds of cannabis-positive urine than buprenorphine patients, but cannabis use did not affect opioid treatment outcomes.
US children's hospital data showed substance-related visits grew 48% from 2016-2021, with cannabis dominating (52% of visits, 82% growth) and Hispanic youth seeing the largest increase.
Veterans who quit smoking had 75% higher odds of reducing cannabis use and 2x higher odds of reducing alcohol use, but quitting did not improve depression, anxiety, or pain.
California CUD treatment admissions declined after legalization, particularly for White males, while increasing for criminal justice referrals and Black and Hispanic patients.
Qualitative study found 14 adults in early opioid/stimulant recovery used cannabis to manage cravings, withdrawal, and psychiatric symptoms while experiencing typical recovery benefits.
Pilot mobile app helped heavy cannabis users cut use from 94% of days to 47% and from 1.42 grams to 0.61 grams daily, with half achieving 50%+ reduction.
Among 311 adults with HIV, current cannabis use disorder was linked to higher apathy scores, but the association disappeared after accounting for depression, suggesting the relationship may be driven by overlapping symptoms.
Among 741 cannabis users, emotion dysregulation was linked to more problematic use in men but less so in women, suggesting cannabis treatment may need sex-tailored approaches to emotional skill building.
Survey of 194 regular cannabis users at French music festivals found 63.4% met dependence criteria, with over 40% reporting health or social consequences and higher rates of stimulant and hallucinogen co-use.
A brief two-session personality-targeted school program reduced cannabis-related harms by 22% over 7 years in high-risk Australian adolescents, though it did not significantly reduce cannabis use itself.
CBD reduced nicotine self-administration in mice without affecting food intake, and attenuated both physical withdrawal symptoms and withdrawal-related pain sensitivity, suggesting potential as a smoking cessation aid.
Review argues that standard cannabis use questionnaires are unreliable in psychosis patients due to symptoms, cognitive deficits, and concealment, recommending quantitative biological measures instead.
2022 national survey found 23% of US adults used cannabis, with 30% of users meeting CUD criteria. Over half had co-occurring substance disorders, yet only 16.5% with CUD received any treatment.
Retrospective study of 317 Thai patients with cannabis-induced psychosis found rapid symptom improvement with antipsychotics (primarily risperidone) over 28 days, but 7% were diagnosed with schizophrenia within 1.3 years.
Among 945 depressed/suicidal youth, 12.7% showed high use of all substances and had the most ADHD, substance use disorders, and suicidality, while 23.8% showed moderate alcohol/nicotine/cannabis use.
Growth mixture modeling of 67 cannabis detox patients found two withdrawal patterns: a slow, protracted decline (66%) and a sharp days-2-6 peak followed by rapid improvement (34%), with the peaking pattern linked to lower THC metabolites at admission.
Longitudinal study of 339 young cannabis users found emotional distress coping motives persistently mediated the link between childhood abuse and problematic use into adulthood, while sleep and pain motives were linked to less problematic use.
RCT of 220 non-treatment-seeking youth found 4 weeks of incentivized abstinence reduced cannabis use and shifted 68% toward reduction goals, with benefits persisting 4 weeks after incentives ended, especially in those without CUD.
Meta-analysis of 10 studies and 8,367 participants found cannabis use had no effect on non-medical opioid use during OUD treatment (OR=1.00), challenging policies that require cannabis abstinence for opioid medication access.
Meta-analysis of 19 RCTs found digital interventions reduced young adult cannabis use by nearly 7 fewer days per month at 3-month follow-up, with personalized feedback being the most common active ingredient across programs.
Study of 3,814 CUD outpatients found women with children who used cannabis before treatment were most likely to drop out, with sex moderating the relationship between childcare responsibilities and treatment adherence.
Chronic pain and addiction share a common neurobiological root — reduced dopamine signaling — explaining why pain patients who self-medicate with opioids or cannabis are vulnerable to escalating into misuse.
Longitudinal study of 1,105 veterans found a self-reinforcing cycle: insomnia increased stress, stress increased cannabis use, and cannabis use worsened both stress and insomnia, challenging its use as a sleep or stress remedy.
A Swedish study of 1,820 patients with first-episode psychosis and cannabis use disorder found clozapine and long-acting injectable antipsychotics were most effective at preventing relapse and rehospitalization.
Among 1.56 million Veterans, those with both TBI and cannabis use disorder had 3.26 times higher cognitive disorder risk, suggesting the combination compounds vulnerability to early-onset cognitive decline.
Brain imaging study found people at risk for cannabis use disorder had more fluid and unstable dynamic brain connectivity patterns across multiple networks compared to controls.
A new 8-item screening tool for problematic medical cannabis use was developed from 390 chronic pain patients, focusing on negative consequences rather than dependence criteria, with excellent reliability.
Network analysis of 1,217 weekly cannabis users found daily tobacco co-use strengthened connections between craving, depression, and failed quit attempts in the CUD symptom network.
Meta-analysis of 14 studies found 26.9% lifetime prevalence of cannabis use disorder in people with ADHD, with nearly 3 times higher risk compared to the general population.
Genomic analysis found cannabis use disorder has causal genetic effects on opioid, alcohol, and nicotine disorders, with bidirectional influences. CUD and simple cannabis use are genetically distinct.
Qualitative interviews with 30 people who inject drugs in LA revealed three ways cannabis co-use facilitated reduced opioid use: maintaining cessation, managing withdrawal, and leveraging easier accessibility.
Prospective study of 2,943 trauma survivors found PTSD symptoms predicted increased substance use over time — with prior trauma and demographics determining who was most vulnerable.
In 404 trauma-exposed college students, restricted access to rewarding activities (not inability to feel pleasure) fully explained the link between PTSD symptoms and cannabis misuse.
Study of 80 male subjects found serum BDNF levels were highest in those with both cannabis use disorder and schizophrenia compared to either condition alone or tobacco-only controls.
Pilot trial of 32 patients found VR avatar therapy reduced cannabis use (d=0.80) with effects lasting 12 months in people with dual CUD and severe mental illness, confirmed by urine testing.
Analysis of 12 years of NSDUH data found cannabis addiction was one of four substance addictions that stably predicted suicidal thoughts, planning, and attempts across all survey years.
Among 342 heavy cannabis users at a French clinic, women had 3.9x higher dependence odds despite using less cannabis, and 5.5x higher lifetime PTSD, with most PTSD linked to sexual assault.
Among 163 chronic pain patients on buprenorphine for opioid use disorder, those with lower tolerance for physical discomfort used cannabis and alcohol more frequently.
A crossover RCT with 48 cannabis users found THC eliminated the tendency to look away from cannabis images. CBD did not change this effect, and adolescents responded similarly to adults.
Meta-analysis of 4 RCTs found cannabis users with PTSD still benefited from trauma-focused therapy, but attended fewer sessions and showed less improvement in other substance use.
A study of 1,618 trauma-exposed civilians found that heavy cannabis and alcohol users had worse PTSD and depression symptoms, with all groups peaking at 8 weeks posttrauma.
A Danish registry study of 35,714 schizophrenia patients found cannabis-related cases used less antipsychotic medication but had more hospitalizations, suggesting a potentially distinct clinical profile.
Among 143 first-episode psychosis patients, cannabis use at program exit was linked to fourfold higher relapse risk and one-third the odds of continuing psychiatric care.
A 10-year follow-up of 192 first-episode psychosis patients found four symptom trajectories, with frequent cannabis use delaying remission and stimulant use triggering relapse.
A study of 4,448 Texas college students found four cannabis-tobacco co-use patterns that remained largely stable over three years, with 42% of students using at least one substance.
Survey of 550 opioid addiction patients found 23% use CBD — primarily for anxiety, pain, and sleep, with 42% using it specifically for withdrawal relief.
A Jamaican national survey found 53% of past-year cannabis users met criteria for severe problematic use, with early start age (before 25) being the strongest predictor.
A cessation trial secondary analysis found that among 500 Black adults, blunt use during a quit attempt did not significantly reduce odds of quitting cigarettes at 12 or 26 weeks.
Analysis of 1,789 urban adolescents identified five distinct substance use patterns, with mental health and perceived drug access differentiating higher from lower risk groups.
National survey data from 2022 found most US cannabis users consumed multiple product types, with consistent patterns between adults and adolescents and correlates varying by route of administration.
A 12-week RCT found zolpidem prevented early cannabis withdrawal sleep disturbance but did not significantly increase quit rates (27% vs 15%), with sleep problems returning after medication stopped.
An RCT of 84 adolescent inpatients with cannabis use disorder found mindfulness therapy added to standard care did not improve cannabis outcomes at 6 months, though standard care was effective.
A pilot RCT of 28 adults with ADHD and cannabis use disorder found extended-release amphetamine significantly reduced cannabis use days but not overall abstinence rates.
A 21-day diary study of 237 college students found co-use of alcohol and cannabis was more pleasurable than cannabis alone, but alcohol appeared to drive the pleasure effect.
Survey of 1,547 New England tobacco users found 26% were dual-vaping nicotine and cannabis, with anxiety and male sex as key correlates.
Analysis of 4.3-5.7 million VA records (2005-2019) found cannabis use disorder diagnoses rose disproportionately among veterans with psychiatric disorders, especially bipolar and psychotic conditions.
Survey of 200 cannabis users found that dependence, emotional dysregulation, and psychopathology predicted other substance use and impaired driving, with no difference between medicinal and black-market users.
Among 152 frequent cannabis users, women on hormonal contraceptives showed weaker brain responses to cannabis cues than naturally cycling women or men, pointing to a hormonal mechanism.
A study identified four distinct cannabis user profiles and found that rapidly escalating users tried to quit most often, while long-term heavy users had the worst cessation outcomes.
An MRI study found that people with cannabis use disorder had increased structural brain connectivity in some regions and decreased white matter density in others.
A review found that the endocannabinoid system modulates alcohol reward, suggesting cannabinoids could help treat alcohol use disorder, but concurrent use carries additional risks.
College drinkers with ADHD had worse sleep and more alcohol-related consequences, but ADHD did not increase cannabis-related negative outcomes.
Boosting the endocannabinoid 2-AG in mice blocked opioid reward without reducing pain relief, suggesting a potential strategy to make opioid treatment less addictive.
A longitudinal study of 7,464 Australian men found cannabis use linked to transitioning from suicidal thoughts to attempts, while alcohol was not.
A systematic review found CBT shows promise for adolescent CUD, with shorter courses and parental involvement most promising.
Medical cannabis laws with dispensaries were associated with declining CUD treatment in 2004-2014, though the effect faded by 2015-2019.
Most tobacco-cannabis co-users tried tobacco first, with nicotine e-cigarettes the most common initial product, especially among teens.
Analysis of 920 participants found reducing cannabis use ~50% in frequency and ~75% in amount was associated with clinician-assessed improvement.
Randomized trial found that A-CRA therapy helped Iranian teen boys with cannabis use disorder achieve higher abstinence and better family relationships than standard treatment.
Legalization strengthened the link between seeing cannabis as low-risk and using it, but broke the link between use and seeking treatment, leading to declining teen treatment admissions.
In nearly 10,000 children, brain structural differences including thinner prefrontal cortex and larger overall brain volume preceded and predicted substance use initiation before age 15.
Cannabis users showed reduced demand when imagining driving but increased demand in sleep contexts with cannabis cues, suggesting safety concerns can override drug motivation.
After controlled THC dosing, cannabis users who felt unsafe to drive showed more impairment — but some who felt safe were still impaired, especially experienced users.
Evening chronotype and cannabis use disorder independently predicted earlier bipolar mood symptom onset, suggesting circadian rhythm disruption may underlie both conditions.
Adults prenatally exposed to cocaine started cannabis younger, and this earlier onset mediated the path to higher anxiety and more severe cannabis use in adulthood.
Among 360 Swiss cannabis users, depression and ADHD specifically predicted heavier use after controlling for other factors, while anxiety and psychosis associations disappeared.
A mouse model of high-dose prenatal THC exposure found offspring developed anxiety, depression, cognitive problems, and increased alcohol preference, with sex-dependent effects.
Only 9 studies address tobacco-cannabis co-use treatment. Combined therapy showed promise with no compensatory use.
Study of 104 psychotic disorder patients in Greenland found 68% had harmful cannabis use and 80%+ smoked daily.
Irish survey of 4,400+ teens found peer cannabis use was the strongest risk factor (10x odds).
Crossover trial: THC increased attentional bias toward cannabis cues; CBD at three doses did not help.
LGBTQ+ dual users who also used cannabis had smaller reductions in cigarette smoking during quit attempts, especially on cannabis-use days.
Propensity-matched analysis of 216K+ young men found cannabis use disorder was not significantly linked to atrial fibrillation after excluding tobacco users.
Preschool executive control problems predicted harsher parenting in adolescence, which in turn predicted higher teen e-cigarette use, though not cannabis or alcohol use.
Prenatal cannabis oil exposure altered VTA dopamine neurons in male mice (disinhibited firing) but did not increase cocaine-seeking in either sex.
Neglected adolescents were more likely to develop impulsive decision-making that led to increased cannabis use over time, identifying a specific prevention target.
US data from 2010-2019 showed cannabis use rising across all drinking levels while tobacco fell, with the fastest cannabis increase among non-drinkers.
Higher mindfulness skills in Argentine college students were linked to less cannabis use through reduced emotional distress and lower coping-based use motives.
Five-year study found heavy cannabis users with disrupted cortisol stress responses had 3.2x higher odds of suicidal thoughts and behaviors.
National US cohort study found legalization increased cannabis use but had no effect on tobacco use or cannabis-tobacco co-use from 2017-2021.
Among 297 people using both cannabis and stimulants in Vancouver, 45% reported using cannabis to manage stimulant cravings, with 78% of those reporting decreased stimulant use.
Cannabis use disorder worsens PTSD through psychological inflexibility — rigid, avoidant thinking that prevents trauma processing — a mechanism that's treatable with targeted therapy.
Scoping review found growing evidence linking endocannabinoid system dysfunction to ADHD, potentially explaining both high cannabis use rates and popular perception of cannabis as therapeutic for ADHD.
Swedish mixed-methods study found that cannabis, alcohol, and gambling users largely share the same barriers to treatment: privacy concerns, stigma, and poor availability.
Review of randomized controlled trials found 10 medications across 8 neurotransmitter systems showing promise for cannabis use disorder, though none yet has strong enough evidence for approval.
Matched-cohort study of 208 ACL reconstruction patients found no significant differences in opioid use or recovery outcomes between those with and without cannabis use disorder.
Study of 616 untreated substance users found cannabis use was not associated with suicidal thoughts, while methamphetamine and heroin use were strong independent predictors of suicidality.
Pilot study of telehealth counseling plus smartphone-based interventions for young cannabis users showed 100% engagement and 27% reduction in use days at 2-month follow-up.
Population study found glioblastoma patients with cannabis use disorder had more surgical complications (32% vs 15%) and neurologic problems at follow-up, challenging claims of cannabis neuroprotection.
In 183 veterans treated for PTSD + substance use, ongoing cannabis use didn't predict worse PTSD symptoms or dropout at subsequent assessments — though concurrent heavy drinking was associated with worse symptoms.
Italian study of 335 impaired driving recidivists found polydrug use doubled recidivism risk, with the cocaine-cannabis combination specifically flagged as a risk factor.
National analysis of 1.6 million urologic cancer surgeries found CUD prevalence increased 7-fold (2003-2014) and was linked to 31% longer stays and 33% higher costs, but not more complications.
French ER study found nearly 1 in 4 young visitors (16-25) were using cannabis, with strong associations to unemployment, sexual abuse history, and alcohol problems.
First study of drug use in Burkina Faso prisons found cannabis was the most common drug (71% of users), with one-third of in-prison users starting drug use while incarcerated.
NIDA leaders identify critical research gaps: effects of high-THC cannabis during brain development, therapeutic endocannabinoid system manipulation, and CUD treatment strategies.
Spine surgery patients with CUD had 2.6x more readmissions and 3.4x more reoperations after neck fusion, but paradoxically fewer medical complications at 6 and 12 months.
Study of 140 adults in addiction treatment found those with ADHD started substance use younger and had higher rates of cannabis, alcohol, and methamphetamine use.
RCT of 1,489 university students found the Minder app significantly reduced anxiety, depression, and cannabis use frequency over 30 days, with 77% engagement.
Systematic review found only 5 RCTs on integrated treatment for psychiatric disorders in cannabis-using youth, revealing a critical gap for depression, bipolar, anxiety, and PTSD.
National study of 113,000 young adults found daily cannabis use associated with 1.7-1.8x violent behavior in males, while any cannabis use was linked to 1.6-2.4x higher odds in females.
In a study of over 680,000 patients, semaglutide was associated with 40-56% lower risk of new cannabis use disorder and 38% lower relapse risk compared to other obesity and diabetes medications.
PET imaging shows cannabis users with trauma have 15-20% higher mGlu5 glutamate receptors in frontal and limbic brain regions — a molecular link between the endocannabinoid and glutamate systems.
Analysis across four studies found that shifts toward using cannabis for multiple motives predicted worse outcomes, offering a foundation for adaptive, personalized interventions.
National survey of 46,499 workers found a clear dose-response: mild CUD increased work-skipping 1.6x, moderate 2.0x, and severe 2.9x, with 15.9% of full-time workers reporting past-month cannabis use.
Among 299,496 pregnancies, psychiatric disorders increased prenatal cannabis use 1.6-2.8x and substance use disorders increased it 4-22x, suggesting widespread self-medication during pregnancy.
Among 45,151 tobacco quitline callers, 27% also used cannabis and had lower 7-month smoking quit rates (23% vs 29%), though 43% of co-users wanted to quit cannabis too.
Study of 115 young adults found no social cognition deficits in those with cannabis use disorder compared to controls, even after accounting for dosage, recency of use, and other substance use.
Young adults with cannabis use disorder showed significantly lower verbal IQ (d = 0.86) but no deficits in executive function, working memory, attention, or episodic memory.
From 2002-2019, daily cannabis use nearly doubled while CUD rates among daily users dropped almost 50%, contrasting sharply with stable AUD rates among daily drinkers.
Among 26,276 youth aged 12-25, the rate and severity of cannabis use disorder among users was consistent across all age groups, suggesting stable vulnerability regardless of age.
Longitudinal study of 584 Canadian emerging adults found bisexual identity strongly associated with both child maltreatment and at-risk cannabis use.
Baseline data from 79 Australian youth found those with substance use disorders had worse depression, anxiety, and more frequent cannabis use than substance-using peers without a disorder.
JAMA Psychiatry neuroimaging study found cannabis use disorder linked to elevated dopamine function in the same midbrain region associated with psychosis.
Rat study found CBD prevented morphine-induced pain hypersensitivity in both sexes and partially reduced withdrawal symptoms, with sex-dependent response patterns.
National survey of 119,000 adults found 14.7% used cannabis in the past month, with smoking dominant but multimodal use rising and strongly linked to tobacco patterns.
Study of 1,476 Black adults with criminal justice contact found marijuana use linked to family stress and sleep problems in men, neighborhood stressors in women.
Qualitative study of 12 young Iranian women found family dysfunction and relational trauma drove cannabis use as a coping mechanism for unresolved emotional needs.
Case of a 26-year-old with autism who developed obsessive cannabis use and severe food restriction, requiring integrated multidisciplinary inpatient treatment.
Survey of 413 women found younger women substituted THC for alcohol driven by sleep problems (OR 5.82), while older women substituted less and were driven by PTSD symptoms.
Genetic analysis of 200,000+ individuals found cannabis use disorder and schizophrenia share genetic roots — polygenic liability for each independently predicted the other condition.
Genetic risk scores for cannabis use disorder predicted schizophrenia even in people without documented cannabis use, suggesting shared genetic pathways between the two conditions.
Nationally representative survey of US high school students found higher adverse childhood experience scores significantly predicted more frequent cannabis use.
Psychosocial screening at first prenatal visit found being unpartnered tripled the odds of prenatal cannabis use, supporting routine screening for targeted intervention.
In a study of 128 opioid maintenance therapy patients, 41% used cannabis and 73% of those met dependence criteria, with medication type influencing use patterns.
Survey of 3,159 Asian Americans during COVID-19 found racial discrimination was specifically linked to cannabis use for coping, while general pandemic stress drove alcohol and tobacco use.
CBD dose-dependently reduced binge-like alcohol drinking in mice, with the effect maintained over repeated dosing and evidence pointing to a novel neuropeptide S receptor mechanism.
Seven years after legalization, Canada's cannabis surveillance still uses outdated diagnostic frameworks, excludes key populations, and can't reliably measure whether legalization has increased or decreased harms.
Review of emerging CUD pharmacotherapies found no approved medications but several promising investigational compounds targeting endocannabinoid and motivational pathways.
Genomic analysis found genetic predisposition to tobacco and alcohol use causally accelerated biological aging, with mixed but suggestive evidence for cannabis use disorder.
First randomized trial of legal vs illegal cannabis found a trend toward reduced misuse with regulated access, with benefits concentrated among polysubstance users.
Study of 588 methadone patients found psychiatric comorbidity was associated only with increased cannabis use, not opioid, cocaine, or alcohol use.
A non-psychoactive cannabis extract reduced cocaine preference extinction time and blocked priming-dose relapse in mice, with serotonin receptors mediating the effect.
Longitudinal study of rural reservation-based youth found 12th-grade cannabis use predicted 21-24% increased loneliness risk six months after high school.
Analysis of 192,580 CUD treatment episodes found California's recreational legalization was associated with lower treatment retention and successful discharge rates.
Decision tree analysis of 8,915 Canadian teen cannabis users found using 2-4+ times per month was the strongest predictor of problematic use, with early onset and solitary use adding risk.
EMA study found cannabis-alcohol co-use produced greater intoxication than either alone, with the intensity of co-use intoxication predicting hazardous cannabis use up to 12 months later.
Survey of 118 German opioid maintenance patients found 60% used cannabis, with most using it as a deliberate harm reduction strategy to reduce heroin and benzodiazepine use.
Cannabis use was significantly linked to depression and anxiety among sexual and gender minority young adults, highlighting the need for targeted interventions in this population.
Nationally representative Canadian data showed bisexual women had the greatest cannabis use and mental health disparities compared to heterosexual peers.
Study of 106,000 European teens found those who perceived COVID as negatively impacting their lives had significantly higher cannabis and other substance use.
Latent class analysis of 4,031 young adults found moderate oil/concentrate users had the worst outcomes across problematic use, mental health, and impaired driving measures.
Meta-analysis of 17 RCTs found brief drug interventions did not reduce cannabis use in general medical settings, though emergency department delivery showed some promise.
Survey of 1,833 Ugandan secondary school students found 2.6% marijuana use, with male sex (2.2x odds) and mental illness history (2.9x odds) as the strongest predictors.
Study of 75 adults found 21.3% underreported substance use when hair tests were compared to self-reports, with cannabis frequency and quantity (but not duration) predicting detection.
Among 59 pregnant cannabis users, 61% continued using in the past month, with most using daily and many reporting failed quit attempts. Having five or more reasons for use made continued use 10 times more likely.
Large European case-control study found cannabis-associated psychosis risk declined after quitting and returned to never-user levels after about 37 weeks, though heavy high-potency users may retain elevated risk longer.
Study of 8,158 cannabis users found they took fewer hits of concentrates than flower (suggesting some self-titration), but users who preferred higher-potency products consumed them in larger amounts and more frequently.
Study of 4,134 daily cannabis users found median consumption of 130 mg THC per day, with 65% meeting DSM-5 criteria for cannabis use disorder. Higher daily THC predicted greater severity.
Interviews with 13 pregnant sexual minority young people found cannabis use was driven by stress and mental health, with pregnancy motivating reduction attempts but some struggling to quit.
Brain imaging of 23 cannabis users and 6 controls found no differences in motor cortex activation between heavy, moderate, light users and non-users during motor tasks.
Daily diary study of 318 college students found cannabis co-use days were associated with heavier drinking, with more cannabis use predicting higher-intensity alcohol consumption.
fMRI study found people with cannabis use disorder had reduced prefrontal activity when evaluating effort/reward but increased posterior cortical activity during integration, despite similar behavioral choices.
Daily diary study found male college students were 7 times more likely to use cannabis the day after experiencing cyber dating abuse, while women showed no such pattern.
Irish longitudinal study of 4,554 youth found earlier alcohol initiation and risky teen drinking independently predicted cannabis and drug use at 20, with dose-response patterns persisting after extensive adjustment.
Survey of 3,490 Norwegian adolescents found 65% of cannabis users reported harms (averaging 4.7), with shame (44%) and adverse effects (42%) most common, predicted by early initiation and alcohol co-use rather than frequency.
fMRI analysis found naltrexone restored brain connectivity disruptions associated with co-occurring cannabis and opioid use disorders, primarily in the default mode network, suggesting potential as a CUD treatment.
Study of 192 young adults found cannabis use disorder was associated with lower oral bacterial diversity and more anaerobic bacteria compared to other substance use disorders, with heavier use linked to greater changes.
Blood tests from 8,328 injured Canadian drivers found 54.9% positive for at least one substance — THC was the most common drug detected after alcohol in this post-legalization dataset.
Controlled trial of 130 participants found single-dose THC impaired cognition but did not worsen psychosis in people with schizophrenia and cannabis use disorder, though higher THC blood levels predicted worse negative symptoms.
Study of 115 college cannabis users found imposter syndrome was linked to more cannabis problems through a pathway of social anxiety leading to coping-motivated use.
Study of 254 Black American cigarette smokers found racism-related emotional distress (but not general anxiety or depression) was linked to cannabis problems, partly through increased cannabis consumption.
Retrospective study of CVS patients found 19% used cannabis and treatment response was best when patients stopped opioids and cannabis alongside low-dose amitriptyline therapy.
California survey of 21,463 adults found alcohol-cannabis co-use highest among White (17%) and multiracial (17.7%) adults, with Hispanic, Black, and Asian populations less likely to co-use.
Longitudinal study of 6,811 Army veterans found cannabis use and other substance use predicted subsequent suicidal ideation and planning, with interactions by sex and depression status.
Large study across four African countries found cannabis and other substance use patterns among people with psychosis varied significantly by country and sex, differing from Western research findings.
In morphine-dependent monkeys, THC modestly reduced some withdrawal signs but was not more effective than existing medication lofexidine, while CBD had no effect alone or combined with THC.
Nationally representative longitudinal study found COVID stay-at-home orders doubled depression odds, but worsening mental health was associated with less marijuana use (78% reduction), contradicting the self-medication hypothesis.
Black MSM reported higher cannabis and tobacco use than non-MSM, with path analysis showing cannabis refusal self-efficacy mediated the link between MSM status and tobacco use.
Pilot RCT found brain stimulation (HD-tDCS) was safe and feasible for cannabis use disorder with 91.7% completion, but cannabis cue exposure during stimulation did not add benefit.
32-year analysis found cannabis use declined among most US adolescents but not among those with suicidal thoughts or attempts, with female suicide attempters showing a persistent plateau.
Reddit analysis found cannabis narratives distinctly featured school settings and self-awareness, while alcohol centered on leisure and opioids on healthcare, with recovery strategies varying by readiness stage.
Reddit analysis found people in substance recovery naturally use 11 types of behavior change techniques, with strategies shifting across recovery stages but stigma persisting throughout.
Among 182 first-episode psychosis patients in South Africa, cannabis use was linked to worse psychotic symptoms across multiple domains, with HIV-positive cannabis users showing additional burden.
ML analysis found different predictors of sustained cannabis vaping by legalization status: cigarette use and bullying in legal states vs heroin use and nicotine vaping in non-legal states.
Cannabis treatment admissions among US adults 50+ rose substantially over two decades but were proportionally overtaken by other drug admissions, with racial and legal-status disparities.
NSDUH analysis found adults 65+ with cannabis use disorder endorsed far fewer diagnostic criteria, especially hazardous use and withdrawal, suggesting potential underdiagnosis.
Montreal study found the cannabis-nicotine combination had the worst association with anxiety and positive mental health among young adults, while substance count showed no dose-response.
Study of 17,423 COVID-19 patients found cannabis and other substance use linked to more ICU admissions and longer hospitalizations but not increased death rates.
Pilot RCT found vortioxetine improved clinician-rated mood in cannabis users over 6 months but did not reduce cannabis dependence or self-reported mood symptoms.
Meta-analysis of 31 studies found male, older, White adolescents who use alcohol or tobacco had the highest odds of vaping cannabis, with Black adolescents having lower odds.
Among 7,178 cannabis users, dual-use (vaping + smoking) was linked to severe externalizing symptoms, while vaping-only was more common among White, higher-income adults.
Survey found 33% of people with hair-pulling or skin-picking disorders used cannabis in the past year, and users had more frequent symptoms and greater distress.
Review found CBT and motivational therapy improve cannabis use outcomes short-term, but effects typically fade by nine months. No medications are approved for cannabis use disorder.
Analysis of 214,505 U.S. adults found cannabis use clustered with heavy drinking, tobacco, and obesity in distinct gender-specific patterns, concentrated in younger and higher-income groups.
Study of 70 adolescent smokers found daily cannabis users wanted more cigarettes but were more sensitive to price increases than non-cannabis users.
Pilot trial with 101 young adults with psychosis found a digital cannabis harm reduction app was feasible (82% retention) and showed early signals of benefit.
Cross-sectional study of 82 methadone patients found childhood trauma correlated with greater pain, more alcohol use, and earlier cannabis initiation.
Study of 1,359 young adult cannabis users identified four spending profiles. Higher-spending groups reported more problematic use.
European longitudinal study finds genetic risk for cannabis use disorder is associated with impulsivity, novelty seeking, and white matter brain changes as early as age 14.
Among 63,713 insured epilepsy patients, 1.1% had cannabis use disorder. Young adults 18-24 were at 5x the risk.
30 years of YRBS data: Black youth have highest cannabis-only use (12.6%), AI/AN youth have highest co-use (20.1%). Disparities have persisted since 1991.
Rat study: CBD accelerated extinction of meth-seeking behavior and prevented relapse. Both effects required D1 dopamine receptors in the hippocampal dentate gyrus.
Global data: cannabis use disorder affects 10.7 million young people (ages 10-24), second only to alcohol (13.3 million). Europe and the Americas have the highest burden.
RCT: motivational therapy plus mobile-triggered support reduced cannabis temptation and dependence more than therapy alone in 70 young adults with CUD.
223 teens seeking to quit vaping: 92% also use cannabis, 69% in the past month. Heavier cannabis use linked to more frequent nicotine vaping.
A large US claims database study found men with cannabis abuse/dependence diagnoses had nearly four times the short-term risk of erectile dysfunction and double the risk of low testosterone compared to matched controls, though effects attenuated over longer follow-up.
A population-level claims analysis found cannabis abuse/dependence associated with 2.8 to 4.2 times higher risk of bladder, kidney, and prostate cancer, even after matching on tobacco use and other risk factors.
Among 104 chronic pain patients on long-term opioid therapy, weaker emotion regulation ability predicted more frequent cannabis use, while pain severity did not, suggesting emotional factors may drive cannabis use more than pain itself.
A systematic review of 49 controlled studies across 11 mental health diagnoses found CBD may offer short-term anxiety relief and CBD/THC combinations helped with cannabis withdrawal and sleep, but THC worsened psychosis and no long-lasting benefits were found for any product.
Two drugs that simultaneously target cannabinoid CB1 and PPAR receptors reduced binge eating in rats and corrected disrupted appetite-regulating brain pathways, offering a potentially safer dual-target approach than CB1 blockers alone.
A study of 4.8 million US adults found recreational cannabis laws produced small decreases in drinking and smoking only after dispensaries opened, with effects varying significantly across age, sex, race, and income groups.
A study of over 2 million pregnant patients found cannabis use associated with 2.7x higher depression, 5.5x higher panic disorder, 10.7x higher suicidal ideation, and 13.6x higher alcohol abuse, though confounding by underlying risk factors is likely.
Year-long monitoring of synthetic cannabinoids in Mayotte identified 13 different compounds across 195 street samples, revealing a market that consolidated under dominant suppliers but whose specific products changed dramatically between monthly campaigns.
A review examines the endocannabinoid system's role in regulating nausea, vomiting, and stress, explaining how chronic cannabis use may dysregulate these processes and contribute to the paradoxical vomiting seen in CHS and CVS.
In 6.4 million diabetes patients, GLP-1 drugs were linked to 37% lower suicide risk, but this benefit disappeared entirely in patients with cannabis use disorder, who faced 5.5x higher risk regardless of medication.
A natural experiment comparing Canadian and US young adults found legalization was associated with less decline in cannabis use over time (attenuated aging out) rather than increased use, with effects emerging 6-12 months post-legalization.
A national US longitudinal study found alcohol and cannabis problems initially predicted fewer sleep issues but later predicted more, while people who used both consistently slept worse than the general population, suggesting a reversing relationship over time.
A study of 512 California young adults found each increase in cannabis flower potency was associated with 3.3 more use days per month and higher addiction scores, contradicting the assumption that people use less of stronger products.
Among 338 young adults, those who primarily vaped cannabis concentrates showed increasing use and problems over time, while edible users had fewer issues due to less frequent use, suggesting different consumption methods carry different addiction risks.
A Swedish study of 7,320 people found cannabis-induced psychosis had the highest relapse rate (25.7%) among all substance-induced psychoses, with 2.42x higher risk than alcohol-induced cases.
A review of 15 studies found chronic substance use generally increases anandamide levels in the blood, suggesting the body's endocannabinoid system is disrupted across multiple types of addiction.
Brain scans of 27 cannabis users with trauma histories showed that trauma reminders increased cannabis craving and activated reward circuits, revealing a potential neural pathway from trauma to problematic cannabis use.
An Ontario population study found cannabis-related hospital visits were associated with 5.4x higher self-harm risk and 9.2x higher suicide risk over 3 years, even in those without pre-existing mental health conditions.
A survey of nearly 3,000 cannabis users in legal US states found two-thirds also used tobacco, with simultaneous use linked to higher cannabis problem severity.
Among people misusing prescription sleep aids, 55.5% also used marijuana, with two profiles: a common alcohol/marijuana/tobacco pattern and a riskier polysubstance pattern.
A pilot in a residential recovery program found clients and staff reported medical cannabis reduced cravings and managed symptoms.
Protocol for a 200-teen RCT testing whether 8 weeks of cannabis abstinence reduces depression and suicidal ideation — using 8 daily phone surveys to capture the moment-by-moment relationship.
A review found CUD treatment success depends on duration, motivation, coping skills, self-efficacy, and therapeutic alliance, with sex, age, and comorbidity predicting who benefits.
Chronic pain patients on medical cannabis reduced opioid use from 40mg to under 3mg daily over a year, but nearly half couldn't tolerate the cannabis treatment.
Biological drug testing in ER patients confirmed cannabis use increased nationally from 2008-2019, with the biggest increases in states that legalized recreational cannabis.
Blood levels of endocannabinoid-related molecules differed in substance use disorder patients, with distinct patterns when ADHD was also present.
Survey of 1,302 small-scale growers: 82% also grew other plants, with most starting as gardeners before adding cannabis.
Canadian study: neighborhood deprivation and gentrification linked to higher cannabis use; immigrant neighborhoods showed lower use.
Among 82,180 pregnancies, partner substance problems were linked to 89% higher odds of prenatal cannabis use.
Projection: German legalization may produce 19x more health harm from increased use disorder than gains from reduced contamination.
Two independent samples confirm cannabis use disorder exists on a continuum of severity rather than as a binary condition, supporting the DSM-5 dimensional model.
Postmortem brain analysis found CB1 receptor gene expression elevated up to 125% and CB2 expression halved in people with long-term alcohol use disorder.
Culturally tailored mobile app for Black adults with cannabis use disorder showed strong feasibility and acceptability plus preliminary efficacy signals in a 50-person proof-of-concept RCT.
Six cannabis user profiles were identified in Washington State, with polymodal users (multiple product types) reporting more adverse events than even the most frequent single-product users.
In nearly 3,000 trauma survivors, household income modified the relationship between PTSD symptoms and substance use, influencing whether people turned to tobacco, alcohol, or cannabis.
Stress increased cocaine use equally in male and female rats, but cannabinoid CB1 receptor blockade reduced intake through different patterns in each sex.
Rasch psychometric analysis of DSM-5 cannabis use disorder in 249 inpatients supports the diagnosis as coherent, though the hazardous use criterion does not fit well.
Childhood adversity increased cannabis use disorder risk across all racial groups, but the effect was strongest among Asian/Pacific Islander respondents and interacted with age of onset in race-specific ways.
Cannabis dependence on top of opioid dependence worsened executive function and working memory deficits, though cannabis use without dependence did not add to cognitive impairment.
In 34 UK patients with substance use disorder, medical cannabis improved anxiety, sleep, and quality of life while reducing prescribed opioid doses over six months, with good tolerability.
In a clinical trial of 192 young people, cannabis use didn't predict whether they successfully quit nicotine vaping—though co-use days showed higher vaping.
Cannabis and tobacco use at any frequency signaled elevated social hardship in 77,000 healthcare users, while binge drinking showed this pattern only at daily frequency.
In college students with elevated worry, fear of anxiety symptoms (anxiety sensitivity) predicted cannabis use and coping motives, while intolerance of uncertainty did not.
Tracked 2,762 college students over a year and found anxiety predicted later hazardous cannabis use, with impulsivity traits amplifying the connection.
Among 13,405 wrist fracture surgery patients, those with cannabis use disorder had double the ER visit rate and higher readmission rates within 90 days.
Brain imaging of 1,003 young adults found heavy lifetime cannabis users had significantly lower brain activation during working memory tasks.
About a third of teen dual users quit both vaping and cannabis at 7 months—and quitting vaping appeared to help with quitting cannabis too.
Analysis of 16 years of national data found CUD treatment rates declined while barriers like cost, awareness, and stigma grew.
Rigorous trial of 192 youth found N-acetylcysteine was no better than placebo for cannabis use disorder when not paired with contingency management.
Study of 1,098 veterans found cannabis use alone was not linked to suicide risk, but combining it with hazardous drinking produced the highest risk for suicidal behavior.
Large database study of ~9 million pediatric patients found cannabis use disorder linked to significantly higher rates of pelvic pain, bladder symptoms, and UTIs.
Mendelian randomization study using genetic data found potential causal links between cannabis use and increased risk of Parkinson's disease and ADHD in women.
Pilot trial of 50 adults found mindfulness-based therapy (MORE) significantly reduced cannabis and cocaine cravings in people being treated for alcohol problems.
Among 3,308 matched hip replacement patients, marijuana users had higher dislocation rates but no difference in opioid use after surgery.
A new brief therapy combining trauma writing with cannabis coping skills showed early promise in three young women after sexual assault—but needs rigorous testing.
Meta-analysis of 22 trials (3,304 people) found MET-CBT significantly increased cannabis abstinence but also had higher dropout rates.
Systematic review of 16 prospective studies found early cannabis use onset specifically predicted cannabis use disorder, not other substance problems.
Analysis of 4+ million VHA patients over 18 years found cannabis legalization drove greater CUD increases among veterans with psychiatric disorders than those without.
National surveys found cannabis use disorder increased 1.4 points more among adults with psychiatric disorders between 2001 and 2013, confirming VA findings.
Comprehensive review found CHS is increasingly common with rising cannabis potency, characterized by daily use for 2+ years, and challenging to treat due to patient skepticism.
Case-control study of 60 people found chronic cannabis users had significantly shorter telomeres than age-matched controls, suggesting accelerated biological aging.
Survey of 15,208 California adults found 37% used cannabis, with 38% of users consuming multiple times daily, primarily from licensed dispensaries.
Rat study found THC+CBD use caused stress responses to generalize to neutral stimuli via astrocyte changes in the nucleus accumbens, but only in males.
Daily diary study of 116 young adults found simultaneous alcohol and cannabis use (overlapping effects) was linked to roughly double the alcohol-related consequences compared to same-day use without overlap.
Large study of 59,529 minority young adults found racial trauma undermined the mental health benefits of psychological well-being, with distinct patterns for multi-ethnic versus mono-ethnic individuals.
Matched cohort study found patients with cannabis-related disorders received more opioid prescriptions and had more ER visits after carpal tunnel surgery, with lower outpatient follow-up rates.
Crossover trial found CBD normalized glutathione, glutamate, and GABA levels in AUD participants who drank the day before, but had no effect in those who abstained.
Crossover fMRI trial found 800 mg CBD reduced precuneus activation during alcohol cue exposure in AUD participants, though craving and mood were unaffected.
Teen cannabis use has held steady despite legalization, but ER visits, child ingestions, and product potency have all increased—changing the risk landscape.
Study of 536 teen tobacco/cannabis users found alcohol use and secondhand smoke exposure were the strongest predictors of same-day poly-product use patterns.
Study of 2,207 young adults found different types of adverse childhood experiences predicted different substance use patterns depending on racial/ethnic background.
Large study of 92,757 college students found OCD conditions independently associated with higher tobacco, cannabis, and alcohol use risk, plus more than doubled disordered eating risk.
Study of 3,823 high schoolers found same-day nicotine-cannabis use was associated with 4.28x higher odds of cannabis dependence symptoms versus using both but on different days.
Study of 1,335 psychiatric inpatients found low conscientiousness, low agreeableness, and high openness to experience associated with cannabis use disorder.
JAMA Psychiatry study of 110 million insured adults found medical cannabis laws associated with 31 more CUD diagnoses per 100,000 per quarter, with recreational laws linked to more cannabis poisoning.
Latent class analysis of 15,429 U.S. postpartum women identified seven substance use patterns, including 5.5% who used cannabis before pregnancy but largely stopped during.
Global Burden of Disease analysis (1990-2021) shows cannabis use disorder is the most prevalent drug use disorder worldwide, with burden concentrated in high-income countries.
In 62,000 Americans, the link between cannabis and psychotic-like experiences disappeared after accounting for methamphetamine, cigarette, and opioid use.
Proof-of-concept with a single OUD patient found vaped cannabis dose-dependently reduced naloxone-precipitated withdrawal scores from 22 to 14 without dangerous vital sign changes.
Study of 400 young adults found rural participants had lower subjective social status, with a mediation pathway through emotion dysregulation to hazardous cannabis use.
fMRI study found women cannabis users had blunted brain responses to cannabis cues compared to men, with unique brain-craving links found only in women.
National survey found cannabis use disorder nearly quadrupled suicidal ideation risk in women veterans, while lifetime cannabis use doubled suicide plan odds.
National analysis found 15.2% of adults using opioids and/or cannabis co-used both, with co-users being younger, poorer, and more psychologically distressed than single-substance users.
Most young vapers want help quitting, but there's no consensus on how—and 40% also vape cannabis, which they see as less harmful than nicotine.
Young adults with cannabis use disorder showed significant drops in heart rate variability and increased heart rate immediately after smoking, measured by wearable smartwatches over 3 days.
Among 22,763 cancer patients, cannabis dependence showed no association with mortality, while alcohol and opioid dependence were significant predictors of death even after adjusting for tumor stage.
A longitudinal sibling study found early-onset cannabis use was the strongest predictor of arrest, probation, and incarceration by age 18, outperforming childhood ADHD, oppositional behavior, and anxiety/depression.
In 4,808 adolescents, genetic predisposition to sensation seeking predicted early substance and alcohol use by age 15, while no impulsivity-related genetic scores predicted cannabis initiation specifically.
A placebo-controlled trial of 36 youth with alcohol use disorder found single-dose 600mg CBD had no effect on brain chemistry, alcohol cue-reactivity, cravings, or drinking behavior.
Among 1,242 people with chronic pain using illicit opioids in Vancouver, daily cannabis use was associated with 40% higher rates of opioid cessation, with effects stronger in men.
Among 1,300 U.S. adults who drink and smoke tobacco, 67% use both simultaneously, 56% also use cannabis, and over 40% combine tobacco and cannabis in the same session.
A nationally representative survey found 26% of medical and 21% of recreational past-month cannabis users met CUD criteria, with daily users reaching 31-32%.
A two-week self-guided online intervention helped 69% of cannabis users meet reduction goals, vs. 49% in the control group.
Treatment-seeking adolescents used multiple cannabis products including delta-8 and delta-10 THC.
Cannabis purchase task measures predicted young adult use frequency three months later.
A 28-day daily diary study found cannabis use days were associated with slightly more physical activity, more drinking, and more cigarette smoking.
A systematic review of 42 studies found high-potency cannabis may be linked to problem use, but evidence was "very low" certainty across all health domains examined.
GDNF brain injection in cannabis-addicted rats reduced anxiety, reversed sperm morphology damage, decreased DNA damage, and improved sperm viability.
In a smoking cessation trial, 47% of participants also used cannabis and increased their cannabis consumption while reducing cigarettes at similar rates to non-users.
A 9-year LA study found most young cannabis users were "Uncontrolled," but harm-reduction rules like avoiding use at work and while driving increased after legalization.
In a Kaiser prenatal program, 80% of 20,398 cannabis-positive pregnancies completed assessment and 88% of those needing help attended counseling.
An fMRI study found daily cannabis users had normal brain value signals for cannabis but disrupted signals for food rewards, supporting reward-narrowing theories of addiction.
US national survey data found adults with HIV are 3.35x more likely to co-use tobacco and cannabis, with associations modified by race and state cannabis laws.
Cannabis disrupted brain connectivity patterns in all users, but chronic users showed persistent network changes even when sober—suggesting lasting brain adaptation.
A mobile app successfully collected real-time passive and active data from 95 veterans with PTSD and cannabis use over 3 months, with 92% passive and 68% active data rates.
Adults with opioid addiction and chronic pain who added a daily THC:CBD capsule to their buprenorphine treatment reported less pain and better sleep after three months, though opioid cravings did not significantly change.
Year-long interviews with people on opioid addiction treatment found they reported less pain, better mood and sleep, and fewer drug cravings from medical cannabis, though cost and appetite changes were concerns.
An Australian national survey found 6.2% of cannabis users met criteria for high-risk use, with daily consumption, starting before age 15, and psychological distress as the strongest predictors.
A three-year brain imaging study found heavy cannabis users developed significant thinning in a brain region crucial for decision-making, with greater thinning linked to more severe use patterns.
Machine learning identified a brain connectivity pattern that predicted problem cannabis use across three independent samples, including college students, European teens, and treatment-seeking adults.
An EMA study found that college students' morning willingness and social motives predicted same-day simultaneous alcohol and cannabis use, creating a window for potential digital interventions.
Analysis of nearly 69,000 suicide deaths found that more permissive cannabis policies and cannabis involvement were both linked to higher odds of opioid involvement in these deaths.
A study of 157 young people in opioid addiction treatment found cannabis use disorder predicted shorter retention, while depression and PTSD were linked to staying in treatment longer.
A survey of 4,134 daily cannabis users found older adults used less potent products, but their risk of cannabis use disorder per milligram of THC was similar to younger users.
Young smokers with cannabis dependence perceived fewer downsides to smoking, and younger people preferred app-based cessation therapy over face-to-face.
A randomized trial of 66 adults found that a brief (~16-day) mindfulness program did not reduce cannabis use, cravings, or quantity compared to relaxation or monitoring alone.
National Medicaid data showed substance use disorder prevalence quadrupled among autistic adults from 2012 to 2016, with cannabis disorders particularly elevated in those aged 30-64.
A genetic study found social isolation causally increases cannabis use disorder risk by over 4-fold, with depression acting as a key mediator explaining about 22% of the effect.
A meta-analysis of 25 studies found cannabis use linked to suicidal thoughts (46-78% higher odds) and attempts (117% higher in teens) even after accounting for depression, though depression partly explains the connection.
Among 206 pregnant women with opioid use, over 80% used tobacco (unchanged across trimesters) and about 30% used cannabis in early pregnancy, declining to 17% by the third trimester.
Among 13,477 ED patients with substance diagnoses, cannabis-related conditions were linked to 21% higher overdose odds, with Black, Hispanic, and publicly insured patients at disproportionate risk.
Analysis of millions of VHA patients from 2005-2022 found cannabis legalization was associated with small increases in opioid use disorder, with the largest effects in older adults with chronic pain.
European analysis shows cannabis-related treatment admissions rose to 37% of all substance treatment entries by 2020, but only 3% of frequent users sought help, indicating a widening treatment gap.
German national data shows cannabis-related medical diagnoses tripled between 2009 and 2021, rising faster than use prevalence, with the biggest increases in middle-aged adults.
Synthetic control analysis of 5 states found recreational cannabis markets increased use prevalence by 11% in teens, 17% in young adults, and 33% in adults 26+, with an 82% increase in new adult users.
Study of 148 people with cannabis use disorder found women used cannabis more in negative emotional contexts than men, with childhood stress linking to coping-motivated use in both genders.
CBD given during repeated social stress in mice prevented social avoidance and enhanced cocaine vulnerability while normalizing serotonin, endocannabinoid, and stress hormone gene expression.
Study of 15,000+ Washington young adults found cannabis use rose through age 22 then plateaued, with social acceptability and low perceived harm as the strongest drivers.
Quebec birth cohort found teens who started cannabis early and used frequently had 51% more mental health visits and 86% more physical health visits by age 23 compared to nonusers.
Global Burden of Disease data shows cannabis use disorders affect an estimated 5.6 million people in the Americas (31.5% of all drug use disorders), second only to opioids.
Analysis of national survey data found medical cannabis laws reduced opioid misuse by 43% among cannabis users, but had no effect at the population level.
Survey of 3,900 Japanese cannabis users found cannabis was rarely a gateway to harder drugs, with odds of progressing to methamphetamine at just 0.08.
RCT of 1,078 young adults found text-message motivational treatment advanced participants through stages of change, resulting in 50% lower THC levels and 4 fewer use days at 6 months.
RCT of 1,078 young adults found text-message CUD treatment worked indirectly through increased motivation and harm reduction strategies, reducing cannabis use at 6 months.
Survey of 472 SUD treatment patients found cannabis flower dominates use patterns, with THC potency driving purchases, though some chose CBD for perceived medical benefits.
Interviews with 23 Canadians in cannabis treatment found recreational use is still seen as masculine, women face extra stigma, but legalization may be shifting these norms.
Survey of 544 SUD treatment patients found cannabis use linked to more trauma and psychiatric diagnoses, but trauma may explain the cannabis-mental health connection.
Japanese national survey found cannabis patients were younger with less severe disorders than methamphetamine patients, but less connected to recovery support services.
Analysis of 7 CUD trials found urinary THC dropped about 50% in self-reported reducers, but no reliable individual-level cut-point could be established.
Five-year Canadian prospective study found cannabis use increased modestly after legalization while misuse decreased, with the largest improvements among frequent pre-legalization users.
Rigorous analysis of Medicare chronic pain patients in 7 states found medical cannabis laws had no measurable effect on opioid treatment or overdose-related healthcare.
Study finds a link between more frequent cannabis use and greater gambling involvement, suggesting shared risk factors.
Hospital admissions for cannabis use disorder among pregnant women are increasing, highlighting a growing clinical concern around prenatal cannabis exposure.
Survey of 1,052 CHS sufferers finds high ER and hospital use, with heavy daily cannabis use and adolescent onset linked to more frequent episodes.
Genetic study finds leisure screen time increases cannabis use disorder risk by 43%, with smoking initiation mediating over half the effect. Sedentary desk work was protective.
Updated CHS management review recommends dopamine antagonists for acute episodes and treating underlying mental health conditions alongside THC cessation.
Among 973 people with HIV, anxiety and tobacco use were the strongest predictors of higher-risk cannabis use, with over a third screening positive for cannabis use disorder risk.
Massachusetts ER data shows CHS cases surged 14-fold from 2012 to 2021, with young adults, Hispanic, and Black populations most affected.
Among 827 opioid pain patients, tobacco and cannabis use were linked to more pain, psychiatric problems, and opioid misuse concerns, while alcohol showed the opposite pattern.
Survey of 1,796 Australian medical cannabis users finds 43% met CUD criteria, with use frequency and mental health mattering more than whether cannabis was prescribed.
Study reveals two distinct pathways from ADHD to cannabis problems: inattention directly causes functional impairment, while hyperactivity drives heavier consumption leading to dependence.
Birth cohort study finds prenatal cocaine exposure leads to more marijuana use by age 21 through a chain of executive function deficits at 12 and substance use at 15.
National data on 40,054 teens with CUD shows only 37% complete treatment, with Black adolescents and those experiencing homelessness facing the lowest completion odds.
New THC vapor self-administration model shows female rats work harder for THC than males and that prior THC exposure increases later use, revealing sex differences in cannabis reinforcement.
Pilot RCT finds full-spectrum CBD with trace THC reduced alcohol craving in people with AUD, while CBD without THC did not, suggesting the trace THC component matters.
Among 540 older adults across the dementia spectrum, moderate cannabis use was not associated with worse cognitive test performance—though problem use may differ.
Meta-analysis of 29 studies finds cannabis use in schizophrenia linked to 40% higher suicide attempt odds and 21% higher suicide death risk.
Two-year study finds 40% of cannabis-using chronic pain patients at high CUD risk with worse mental health, but pain outcomes do not worsen compared to non-users.
A review warns that 30 years of rising methamphetamine and high-potency cannabis use have fueled a growing wave of drug-induced psychosis, with up to half of cases progressing to schizophrenia.
An Ontario study of 11.6 million people found that individuals hospitalized for cannabis use disorder were nearly 3 times more likely to die within 5 years, with especially high risks for suicide and trauma.
An Ontario study of 13.6 million people found the share of schizophrenia cases linked to cannabis use disorder nearly tripled from 3.7% to 10.3% during a period of cannabis policy liberalization, reaching 18.9% among young men.
An Ontario study of 6.1 million adults over 45 found that those with emergency visits for cannabis use had 1.72x higher dementia risk than the general population, though lower risk than those with alcohol-related visits.
Sixteen Iranian psychiatrists identified reduced stigma and patient empowerment as potential benefits of demedicalization of cannabis use disorder, while warning of treatment challenges and normalization risks.
Chronic CBD from weaning reversed anxiety, brain molecular changes, gut microbiota dysbiosis, and increased alcohol motivation in mice with fetal alcohol exposure, with effects varying by sex.
A study of 93,743 US adults found that cannabis use mediated a larger share of the link between depression, pain, and suicidal behavior in women than in men.
A study of 152,930 US adults found that using cannabis and opioids together was associated with a smaller-than-expected increase in suicidal behaviors, particularly in women.
Interviews with 20 young adults found stronger motivation to quit nicotine vaping than cannabis vaping, with addiction, mental health coping, and identity as key barriers, and health concerns as the main facilitator.
A 30-day daily diary study of 111 young adults found that vaping nicotine and cannabis on the same occasion was linked to the highest consumption intensity for both substances.
A brain imaging study found men with opioid use disorder had 15% lower cannabinoid CB1 receptor availability than healthy controls, particularly in emotion-processing regions.
A study of 167,504 teens found five substance use patterns, including a cannabis-centered class, and all groups had higher rates of depression, suicidal ideation, and violence than non-using peers.
A nationally representative study found 8.9% of US workers in their early 30s used substances at work, with 3.1% using marijuana, highest in food service and safety-sensitive jobs.
Among 530 psychiatric inpatients, cannabis use was linked to lower suicidal intensity in women but not men, with low psychological flexibility amplifying risk in male cannabis users.
Germany's 2024 national survey found 9.8% of adults (5.1 million) used cannabis in the past year, with 1% dependent, compared to 4.2% alcohol and 8.3% tobacco dependence.
A 3-year study of 279 bipolar patients found cannabis linked to earlier onset and more psychotic symptoms but not more hospital readmissions, while tobacco predicted higher relapse rates.
US adults with disabilities were more likely to vape cannabis (4.6% vs 2.8%), with cognitive disability showing the highest rate at 8.2% and daily nicotine vaping as the strongest correlate.
A mouse study found prenatal THC combined with maternal stress caused additive harm to maternal behavior and offspring brain development, with sex-specific effects on anxiety, motivation, and gene expression.
CBD sped up extinction and prevented reinstatement of methamphetamine-seeking in rats, effects that were partially blocked by inhibiting D2 dopamine receptors in the hippocampus.
A study of five major cannabis companies found significant investment and employee flows from alcohol, tobacco, and pharma industries, raising concerns about profit-driven practices entering cannabis markets.
A study of 731 18-year-olds found parent cannabis use predicted offspring use, but positive parenting in early childhood significantly buffered against cannabis use disorder symptoms.
Twin study of 3,165 adults found cannabis use for sleep linked to worse sleep quality and more substance use, even after controlling for shared genetics.
Daily tracking of 65 young people in cannabis treatment showed cannabis helped sleep in the first two weeks but the benefit disappeared by week three.
Small study of 51 daily cannabis users found risk-seeking predicted more negative consequences, while acting on positive emotions predicted fewer.
Survey of 102 opioid treatment clinicians found most lack medicinal cannabis experience but two-thirds would consider it for patients.
Clinician survey found over half of opioid treatment clients reportedly use cannabis, with recognized benefits for sleep and mental health alongside harms like dependence.
Italian 10-year study found people with cannabis use disorder had 22 times the suicide attempt rate of the general population, highest among women and those with co-occurring psychiatric diagnoses.
Review highlights that Native American communities face unique cannabis policy challenges, with higher youth use rates and multi-jurisdictional regulatory complexity.
Study of 471 college students found eating disorder symptoms linked to cannabis use disorder, with male students showing the strongest association.
Small trial of mindfulness-based therapy for cannabis users showed better adherence and trends toward more durable reduction, but differences did not reach statistical significance.
Review finds cannabinoid hyperemesis syndrome, causing severe vomiting in chronic cannabis users, is increasingly diagnosed in emergency departments and frequently misidentified.
Cannabinoid receptor activation reduced impulsive decision-making specifically in highly impulsive rats, with effects lasting at least two weeks after the last dose.
Study of 2,303 diverse young adults found race- and gender-based discrimination linked to worse cannabis use outcomes but fewer alcohol problems.
Ontario data showed cannabis involvement in PTSD emergency visits rose 151% during cannabis liberalization (2008-2022), outpacing alcohol's 58% increase.
Systematic review found youth cannabis use shaped by multi-level factors: individual perceived risk, peer influence, neighborhood stress, and policy context.
Daily tracking of 65 young adults found social/environmental triggers drove cannabis use more than emotional states, challenging self-medication theories.
Pilot study found strong demand for cannabis use disorder treatment among MS patients, with over half using cannabis and up to 20% at risk for use disorder.
Pilot RCT found telehealth brain stimulation with mindfulness reduced cannabis use by 1.4 days/week and significantly decreased withdrawal in women with MS.
Study found cannabis co-users smoked more cigarettes when asked to switch to alternatives and were less likely to attempt tobacco cessation.
Across 25 African countries, 3.4% of school-going adolescents used marijuana, with bullying, school skipping, and sadness consistently predicting substance use regardless of substance type.
Among 3,050 New Zealand drunk drivers, 27% also tested positive for cannabis and 16% for prescription medications, revealing widespread poly-substance use among impaired drivers.
Systematic review applying Hill causality criteria found cannabis likely contributes to schizophrenia development (OR 2.88), with adolescent use carrying roughly double the risk.
JAMA study of 4,503 older veterans found 10.3% used cannabis monthly, with over a third of users screening positive for cannabis use disorder. Smoking was linked to 3.5x higher CUD odds than edibles.
Narrative review challenged five assumptions about cannabis abuse potential, arguing that medically supervised use carries abuse liability comparable to other prescribed medications.
Study found no consistent attentional bias toward cannabis images in people with moderate-to-severe cannabis use disorder, challenging a core theory of addiction.
In a tobacco cessation trial, cannabis co-users experienced significantly worse withdrawal during week 1 of quitting compared to tobacco-only users, with no difference at later timepoints.
Among 173 Arab American college students, stronger ethnic identity and religiosity were linked to lower cannabis use, with particularly strong protective effects for those with Muslim upbringings.
College students with stronger parasympathetic nervous system responses to stress used cannabis more frequently, suggesting physiological stress sensitivity may drive substance use.
Longitudinal study of 2,015 individuals found heavy drinking, but not cannabis use, was associated with higher unintended pregnancy risk among those wanting to avoid pregnancy.
A rigorous review of 8 studies found THC linked to increased psychosis risk while CBD showed potential therapeutic effects—the two cannabinoids may work in opposite directions.
Umbrella review of 22 systematic reviews found CBD alone is not effective for substance use disorders, but CBD+THC combination (nabiximols) helps cannabis withdrawal and craving.
Real-time monitoring of 36 young adults found cannabis use happened mostly at home, during neutral moods, when craving, and with fewer people around, challenging emotional coping assumptions.
Rats exposed to cannabinoid receptor activation during adolescence showed lasting disruptions in hippocampal brain rhythms critical for memory—even in adulthood.
Among 4,407 young adults, loneliness predicted 20% higher cannabis use disorder risk and more frequent cannabis use, independent of depression and other risk factors.
Monthly monitoring of 772 young adults for 2 years found those who consistently used more cannabis during depressive episodes developed more hazardous use by 30-month follow-up.
Review of 22 studies found daily high-potency cannabis tripled dissociation risk in first-episode psychosis, with worse functional outcomes, though 75% improved after stopping cannabis.
Review of 50 studies found cannabis nearly tripled suicide risk in first-episode psychosis patients, with dose-dependent effects and identified high-risk intervention windows.
Patients who continued cannabis after first psychotic episode had dramatically worse depression, 3x higher relapse rates, persistent suicidality, and no functional improvement over 9 months.
Rigorous RCT found 12 weeks of high-intensity exercise did not improve brain structure or mental health in cannabis use disorder, though 80% of participants completed the program and exercise reduced cravings.
Annals of Internal Medicine review of 99 studies (221K participants) finds high-THC cannabis consistently associated with psychosis and addiction, with mixed results for anxiety and depression depending on therapeutic context.
Longitudinal study found childhood trauma predicts cannabis use in new mothers, with resilience protective at low-to-moderate trauma but losing its effect at high trauma levels.
Retrospective survey of 152 cannabis users found significant psychedelic experiences associated with reduced cannabis use, with 'mystical' quality predicting greater reductions.
Pre-legalization German survey found nearly a third of regular cannabis users experienced external stigma, with medical users and those with use disorder most affected.
Survey found only 9.2% of cannabis consumers sought help for problems, with doctors most common in legal jurisdictions and family/friends preferred where cannabis is illegal.
Analysis of 4,415 cannabis break app users found they were predominantly young daily users seeking mental clarity, with most planning to reduce rather than quit entirely.
fMRI study of 65 treatment-seeking CUD patients found increased brain activation to cannabis cues in executive and reward regions, with an unexpected inverse relationship between craving and reward area activation.
A 21-year-old with prior cannabis psychosis developed catatonia after resuming use, triggering rhabdomyolysis, kidney injury, and autonomic instability.
Two teens with treatment-resistant CHS vomiting (36–45 hours) improved within 1 hour of aprepitant—a potential game-changer for acute CHS management.
The Cochrane Review's second update confirms: no medication has strong evidence for treating cannabis use disorder or reliably reducing withdrawal symptoms.
National survey data showed adolescents with depression or bipolar disorder who use cannabis had significantly higher rates of suicidal ideation and attempts compared to non-users with the same diagnoses.
National treatment data showed cannabis-related admissions fell overall from 2010-2021, but recreational legalization was associated with a delayed increase in treatment-seeking starting four years after implementation.
A 6-month observational study of 58 patients found cariprazine significantly improved both schizophrenia symptoms and cannabis dependence, with large improvements across all outcome measures.
Systematic review found only 11 total studies on technology-based interventions for cannabis use in psychosis, despite the rapid growth of digital mental health tools.
Daily diary study found college students with ADHD used cannabis more frequently, driven specifically by stronger motivation to cope with negative emotions.
60-day study found negative consequences from mixing alcohol and cannabis paradoxically increased cannabis use at the next drinking event while reducing alcohol quantity.
Rats pre-exposed to nicotine became more sensitive to THC reward at low doses and experienced worse withdrawal, suggesting nicotine primes the brain for cannabis effects.
A study tracking teens from age 13 to 25 found early-onset escalating cannabis users had 8x higher odds of cannabis use disorder and 3x higher depression risk.
An analysis of 1.2 million CUD treatment episodes found Black patients received evidence-based therapy at half the rate of White patients, even after controlling for insurance and severity.
A preclinical review suggests partial dopamine agonists like cariprazine could treat both schizophrenia and cannabis addiction by stabilizing dopamine signaling.
College students with type 1 diabetes: 41% used marijuana, with grit and illness acceptance protective while depression increased risk.
Among 616 Mexican American college students who'd never used cannabis, depressive symptoms predicted starting cannabis a year later—family factors didn't buffer it.
Rat study shows CBD helps extinguish meth-seeking behavior and prevents relapse through D2 dopamine receptors in the hippocampus, identifying a specific brain mechanism for CBD's anti-addiction potential.
A pilot study of 10 adolescent CHS patients found universal cannabis use disorder and specific blood profiles that may help diagnose the condition.
CBD reduced opioid self-administration in rats with nerve pain without reducing oxycodone's analgesic effects—a potential path to safer opioid prescribing.
Among 13,088 pregnant women in cannabis treatment, those in legal states had 67% lower odds of completing treatment—only 28.3% completed overall.
Scoping review of RCTs found thin and mixed evidence for cannabis treating mental health conditions — CBD shows some anxiety promise but most psychiatric evidence remains inconclusive.
National database study found cannabis use disorder didn't worsen heart surgery outcomes after matching, but CUD patients had dramatically higher rates of polysubstance use.
Comprehensive preclinical study showed CBD reduced alcohol dependence across every dimension tested — consumption, withdrawal, anxiety, relapse, and brain damage — while leaving non-alcohol rewards unaffected.
Scoping review found CBD failed to beat placebo for cocaine addiction in clinical trials despite promising animal data — well-tolerated but not effective as standalone treatment, highlighting the preclinical-to-clinical translation gap.
Rats developed clear THC tolerance after 7 days of dosing but showed no spontaneous withdrawal symptoms when THC was stopped — even with a sensitive behavioral measure.
Meta-analysis of 7,515 patients found ~34% with cannabis-induced psychosis later developed schizophrenia spectrum disorder and ~11% developed bipolar disorder.
Well-powered rat study found oral CBD did not significantly reduce acute opioid withdrawal symptoms, with limited sex-specific effects in the protracted phase.
Low-dose CBD reduced cocaine self-administration in female mice by altering reward pathways, while higher doses showed paradoxical effects. Males showed no response, highlighting critical sex differences.
fMRI study shows people with cannabis use disorder have heightened brain responses to cannabis cues across salience, motivation, and attention circuits, with activity correlating with arousal and withdrawal.
First pilot trial of H4 deep brain stimulation for cannabis use disorder found the treatment feasible and tolerable — laying groundwork for controlled efficacy trials.
College students misusing stimulants had significantly higher cannabis use, especially nonmedical misusers.
Among people with HIV, cannabis users motivated by medical or emotional reasons had higher polysubstance use than recreational users.
A 12-week RCT found varenicline reduced cannabis use in men with CUD but had no effect in women.
A 12-week virtual group therapy program reduced cannabis use, cravings, depression, and anxiety with 68% retention.
A text-based mobile treatment for young adults with CUD reduced cannabis use at 6 months with equal effectiveness in rural and urban areas.
National survey finds bisexual women had the highest rates of polysubstance combinations involving cannabis and binge drinking.
A controlled crossover trial found cannabis reduced alcohol consumption by 19-27% in heavy drinkers who also use cannabis.
Study of 9,065 college students in seven countries finds polysubstance users had more childhood adversity, impulsivity, and ruminative thinking.
Systematic review of 38 studies finds integrated CBT works for CUD with co-occurring conditions, and AI tools can enhance contingency management.
Daily diary study finds young adults report better sleep quality on days they use alcohol and cannabis together versus alcohol-only or no-use days.
Swedish nationwide study found moderate antipsychotic doses most effective for preventing psychotic relapse after cannabis-induced psychosis — higher doses added no benefit.
In 923,000+ veterans on opioids, cannabis linked to 11% more suicide attempts; tobacco to more attempts, deaths, and overdose deaths.
Survey of 139 Ghanaian pro footballers found 44.6% used substances, with caffeine dominant and cannabis use under 3%.
ABCD Study found racial discrimination in preteens linked to cannabis use intentions through a pathway of increased perceived accessibility and decreased perceived harm.
Major meta-analysis shows cannabis co-use reduces tobacco quit odds by 35%, but CBD interventions cut cigarette consumption by 40%, suggesting a promising new cessation approach.
Systematic review finds 33 clinical trials testing Ozempic-type drugs for addiction, mostly for alcohol and tobacco, with zero trials targeting cannabis use disorder.
Qualitative study found veterans in addiction treatment used cannabis to manage chronic pain, anxiety, and sleep — framing it as a harm reduction alternative to more dangerous substances.
Study found longer cannabis use history linked to weaker automatic movement learning and elevated resting brain activity, suggesting altered baseline neural dynamics.
ABCD Study found early adolescents follow distinct trajectories of cannabis expectancy development, with family monitoring and peer substance use as key factors.
Systematic review finds White participants are represented at 49 times their share of cannabis use disorder cases in treatment trials, with zero studies culturally adapted for people of color.
Pilot study found veterans with PTSD who achieved 12 weeks of cannabis abstinence saw 71% symptom reduction vs. 37% in those who continued using.
A survey of 900 adults with ADHD found 75% had used cannabis, with daily users showing significantly higher rates of cannabis use disorder (62%), anxiety (70%), and worsened inattention compared to non-daily users.
An RCT of 152 Canadian heavy cannabis users found an online self-guided treatment program reduced use frequency and problems, with a brief therapist introduction adding benefit for quantity reduction but not essential for frequency reduction.
A JAMA Psychiatry meta-analysis of 35 trials (4,136 participants) found current psychological interventions provided no meaningful benefit for reducing substance use in people with schizophrenia, except for a small effect on nicotine, highlighting an urgent need for new treatment approaches.
Study of 94 Spanish cannabis treatment seekers found 88% co-used cannabis with tobacco, 76% had withdrawal symptoms (worse in women), with two distinct user profiles.
Healthy controls increased 2-AG endocannabinoid levels after social stress while chronic opioid users showed a blunted response, suggesting a dysfunctional stress buffer that may contribute to opioid vulnerability and relapse.
A university pain clinic study found medical cannabis authorization was associated with a non-significant 14 mg/day decrease in opioid doses, while long-term opioid use status dominated prescribing patterns regardless of cannabis access.
British pharmacology consensus guidelines found no approved medications for cannabis or synthetic cannabinoid dependence — a major gap compared to alcohol, opioid, and nicotine treatment.
Mouse study found low-dose THC increased dopamine and GABA in the brain's reward center while high doses decreased dopamine, and a partial CB1 agonist produced no reward-related effects.
PATH study data from 2016-2021 shows e-cigarette and cannabis co-use rising among young adults while cigarette-cannabis co-use stays flat or declines, reflecting a shifting substance use landscape.
Analysis of 98,820 All of Us participants found a nonlinear relationship between discrimination and cannabis use, with associations varying significantly across sexual orientation and gender identity groups.
Survey of 9,178 youth found earlier cannabis initiation predicted greater difficulty quitting for both American Indian and non-AI students, with AI youth more likely to start before age 14.
Meta-analysis of 9 RCTs found CBT did not significantly outperform other psychosocial treatments for reducing cannabis use frequency, though one measure of daily consumption showed a medium-term benefit.
Rat study found a hemp extract with only 2.5 mg/kg CBD was more effective than 80 mg/kg of pure CBD at reducing meth relapse-like behavior, supporting the therapeutic value of full-spectrum cannabinoid preparations.
Survey of 612 bariatric surgery patients found cannabis use jumped 52% post-operatively, with hazardous drinkers most likely to pick it up.
French surveys of 4,164 cannabis users found most buy from dealers or friends, with problematic use and being male predicting purchasing or cultivation over receiving it free.
ABCD Study found adolescents' mental health improved when household members quit cannabis, mediated by reduced family conflict and better sleep.
National survey data showed 11.4% of U.S. teens ages 12-17 use cannabis, with higher use linked to more missed school and lower grades.
Veteran study found cannabis use disorder rose faster in states that legalized, but increases were similar for male and female veterans with one exception.
NSDUH analysis found 7% of pregnant individuals use cannabis, driven by psychological distress (6x odds) and polysubstance use, while risk perception strongly deterred use.
Survey of 9,100 adults found 45% of cigarette smokers in high-tobacco states also use cannabis, with co-use most common among young, male, and disabled individuals.
National survey of 52,525 people found elevated substance use including cannabis across all sexual minority groups, extending to those using newer identity labels.
Systematic review of 39 studies found cannabis and tobacco co-users showed similar cognitive and brain function to non-users, suggesting the substances may offset each other's impairments.
Large Kaiser study found adolescent cannabis use associated with significantly higher rates of psychotic, bipolar, depressive, and anxiety disorders diagnosed through age 25.
Machine learning models predicted cannabis use disorder progression with 74% accuracy using the All of Us cohort, with demographics and income being the strongest predictors.
German health insurance data from 4 million youth showed cannabis-related diagnoses rose 22% (2013-2022), with 78% having co-occurring psychiatric disorders, especially depression.