Cannabis Harm Reduction Research

Cannabis legalization and cannabis and opioid use in a large, multistate sample of people who inject drugs: A staggered adoption difference-in-differences analysis.

Haley, Danielle F · 2026

Compared to medical-only legalization, adding recreational cannabis legalization was associated with a 9-11% decrease in the probability of daily opioid misuse among PWID (any opioids 95% CI: -14.0 to -4.0; injected opioids 95% CI: -19.0 to -2.0), while daily cannabis use increased mainly among non-Latinx White PWID in states transitioning from no law to medical legalization..

Recent Advances in the Science of Cannabis-Impaired Driving.

Metrik, Jane · 2026

THC acutely impairs driving performance consistently within the first hour of use, with impairment remaining for approximately 4-5 hours post-inhalation.

Acute Effects of Cannabis on Alcohol Craving and Consumption: A Randomized Controlled Crossover Trial.

Metrik, Jane · 2026

After overnight cannabis abstinence, smoking cannabis with 3.1% or 7.2% THC led to significantly less alcohol consumption compared to placebo, reducing intake by 19% and 27% respectively.

Association Between Recreational Drug Use and Cardiovascular Events Post-Hospitalization in France.

Mirailles, Raphael · 2026

Recreational drug users had higher one-year MACCE (major adverse cardiovascular and cerebrovascular events) rates than non-users (12.7% vs.

Changes in clinical features and severity in patients presenting to European emergency departments with acute cannabis toxicity over the 10-year period from 2013 to 2022.

Miró, Òscar · 2026

Among 3,839 ED presentations for lone cannabis toxicity (2013-2022), the most common symptoms were anxiety (35%), agitation (22%), decreased alertness (21%), and vomiting (20%).

Regular cannabinoid use and inflammatory biomarkers: Systematic review and hierarchical meta-analysis.

Murri, Martino Belvederi · 2026

Cannabis use was associated with higher anti-inflammatory biomarkers (SMD = 0.298, PD = 99%) and pro-inflammatory biomarkers (SMD = 0.166, PD = 100%).

Relationships of Changing State Cannabis Policies With Alcohol Policy Effectiveness and Alcohol or Cannabis Involvement in Motor Vehicle Fatalities.

Naimi, Timothy S · 2026

A 10-point increase in alcohol policy scores was associated with 6.3% lower odds of alcohol-involved crash fatalities.

Associations of Cannabis and Tobacco Use with Suicide Attempt, Suicide Death, and Overdose Death Among Veterans Prescribed Opioid Analgesics.

Nguyen, Nhung · 2026

Cannabis use: HR 1.11 for suicide attempts.

Cannabis-Related Healthcare Encounters Among U.S. Commercially Insured Adults.

Perez-Vilar, Silvia · 2026

Among 115 million eligible individuals, cannabis-related healthcare encounter rates increased from 44.0 to 75.1 per 10,000 person-years between 2017 and 2022 (p=0.01).

Racial diversity in cannabis use disorder research: A systematic review.

Reid, Mallet R · 2026

Of 14 cannabis use disorder behavioral health RCTs (1994-2025), White people comprised 64% of participants despite having a smaller share of CUD cases, overrepresented at 49 times their proportional rate.

Medical Cannabis and Opioid Receipt Among Adults With Chronic Pain.

Slawek, Deepika E · 2026

Compared to months with no medical cannabis dispensed, a 30-day supply of medical cannabis was associated with 3.53 fewer daily morphine milliequivalents (MME).

Preoperative Cannabis Use and Ankle ORIF Outcomes: Higher Risks of Infection, Nonunion, and Reoperation.

Tummala, Sri · 2026

After propensity score matching for 27 confounders, preoperative cannabis use was significantly associated with increased risks of postoperative infection (RR=1.696), nonunion, and reoperation following ankle ORIF.

Partial cannabis legalization and the increase of the THC threshold in road traffic: a statistical analysis of traffic cases before and after legal changes.

Wohlfarth, Ariane · 2026

Median THC levels in administrative and criminal traffic offenses were identical (3.44 ng/mL).

Brief Drug Interventions Delivered in General Medical Settings: a Systematic Review and Meta-analysis of Cannabis Use Outcomes.

Berny, Lauren M · 2025

Across 17 RCTs, brief drug interventions showed no significant short-term effects on cannabis use (OR=1.20), consumption level (g=0.01), or severity (g=0.13).

Disparities in use modalities among adults who currently use cannabis, 2022-2023.

Diaby, Meman · 2025

Smoking was most common (77.3%), followed by edibles (37.3%), vaping (34.8%), dabbing (15.0%), topicals (5.9%), sublingual (4.5%), and pills (2.1%).

Prevalence of chemsex and sexualized drug use among men who have sex with men: A systematic review and meta-analysis.

Georgiadis, Nikolaos · 2025

Pooled prevalence of chemsex was 22% and sexualized drug use overall was 25% among MSM.

Accuracy of labeled THC potency across flower and concentrate cannabis products.

Giordano, Gregory · 2025

Labeling accuracy depended dramatically on product type: 96% of concentrates were within 15% of labeled THC versus only 56.7% of flower products.

Binge Drinking, Cannabis, and Tobacco Use and Modifiable Social Risks Among Adults Who Used Health Care.

Glass, Joseph E · 2025

42.1% of past-month cannabis users and 42.6% of tobacco users had at least one social risk, compared to 30.9% overall.

Predictors of Participation in Prenatal Substance Use Assessment, Counseling, and Treatment Among Pregnant Individuals in Prenatal Settings Who Use Cannabis.

Lapham, Gwen T · 2025

80.3% of cannabis-positive pregnancies completed assessment.

Prenatal Cannabis Use and Neonatal Outcomes: A Systematic Review and Meta-Analysis.

Lo, Jamie O · 2025

Cannabis use in pregnancy was associated with increased odds of low birth weight (OR=1.75), preterm birth (OR=1.52), small for gestational age (OR=1.57), and perinatal mortality (OR=1.29).

The adverse public health effects of non-medical cannabis legalisation in Canada and the USA.

Mekonen Yimer, Tesfa · 2025

The review found that cannabis legalization has been associated with several adverse public health outcomes including increased emergency department visits, cannabis-impaired driving incidents, and accidental pediatric exposures, though effects vary by jurisdiction and policy design..

Exploring the link between recreational substances and physical activity in children and adolescents: insights from the Health Behavior in School-Aged Children study (2013-2019).

Miño, Camila · 2025

Among 358,391 children and adolescents across 45 countries, cannabis users did not differ significantly from non-users in physical activity levels.

Legalizing Youth-Friendly Cannabis Edibles and Extracts and Adolescent Cannabis Use.

Mital, Shweta · 2025

Among 106,032 students in grades 7-11, provinces that legalized cannabis edibles saw a 3.8 percentage point (26%) increase in overall cannabis use and 3.4 percentage point (43%) increase in edible use compared to Quebec where youth-friendly products were banned.

State adult-use cannabis policy effects on law enforcement efforts to disrupt drug markets.

Montgomery, Barrett Wallace · 2025

Cannabis legalization significantly reduced overall drug seizures, driven by large drops in cannabis seizures.

The impact of using cannabis during pregnancy on the infant and mother: An overview of systematic reviews, evidence map, targeted updates, and de novo synthesis.

Munn, Zachary · 2025

Across 89 included studies/reviews, prenatal cannabis exposure showed potentially harmful impacts on all fetal growth measures, some neonatal outcomes, some later-life developmental outcomes, and some maternal outcomes.

Minimum Legal Age of Nonmedical Cannabis Purchase Laws and Cannabis-Related Hospitalizations in Canada, 2015 to 2022.

Myran, Daniel T · 2025

Cannabis-related hospitalizations declined by 2% per quarter among individuals below the minimum legal age after legalization, while no slope change occurred for those above the MLA.

The association between state cannabis policies and cannabis use among adults and youth, United States, 2002-2019.

Pessar, Seema Choksy · 2025

Using the Cannabis Policy Scale, a comprehensive measure of 17 state cannabis policy areas, more restrictive policies were significantly associated with lower past-month cannabis use.

Multilevel Risk and Protective Factors Influencing Cannabis Use Among Adolescents and Young Adults in the United States: A Systematic Review.

Phares, Belinda A · 2025

Risk factors operated at every level: individual (older age, early initiation, low perceived harm, polysubstance use), interpersonal (peer influence, parental acceptance, family structure), community (neighborhood stress, social media, proximity to dispensaries), and societal (legalization, lower SES).

Adverse clinical effects associated with the use of synthetic cannabinoids: A systematic review.

Prete, Mariana M · 2025

From 944 studies screened, 49 met inclusion criteria (2010-2022).

Routes of Marijuana Use - Behavioral Risk Factor Surveillance System, 22 U.S. States and Two Territories, 2022.

Quader, Zerleen S · 2025

Using the 2022 BRFSS data from 22 states and 2 territories, 15.3% of adults reported past 30-day cannabis use.

Trends in substance use-related emergency department visits by youth, 2018-2023.

Renny, Madeline H · 2025

Among 151,764 ED visits for 12-21 year olds, substance use accounted for 3.0% overall but increased from 2.8% to 3.4% (p<0.001).

The psychosis continuum: Systematic review on prodromal markers, symptom progression, and early intervention strategies.

Ricci, Valerio · 2025

This systematic review synthesized 60 studies spanning 25 years (2000–2025) to map the trajectory from early warning signs to full psychotic episodes.

Cannabis Retailer Advice on Blunt, Tobacco, and Cannabis Use During Pregnancy.

Young-Wolff, Kelly C · 2025

While 80% of budtenders advised against prenatal tobacco and blunt use, only 40% said prenatal cannabis use was unsafe.

An on-line school-based substance use harm reduction programme: The Illicit Project randomized controlled trial results.

Debenham, Jennifer · 2024

The intervention group showed significantly slower increases in binge drinking (OR 0.33), cocaine use (OR 0.06), and prescription drug misuse (OR 0.07) over 12 months compared to controls.

Association of Cannabis Use Reduction With Improved Functional Outcomes: An Exploratory Aggregated Analysis From Seven Cannabis Use Disorder Treatment Trials to Extract Data-Driven Cannabis Reduction Metrics.

McClure, Erin A · 2024

In 920 participants across 7 CUD trials, reductions in use were associated with improvements in cannabis-related problems, clinician ratings, and sleep.

Cannabis use disorder and perioperative outcomes following complex cancer surgery.

Munir, Muhammad M · 2024

After propensity score matching, CUD was associated with slightly higher AKI (7.8% vs 6.1%) but lower in-hospital mortality (0.9% vs 1.6%).

Cannabis-involvement in emergency department visits for self-harm following medical and non-medical cannabis legalization.

Myran, Daniel T · 2024

Among 158,912 self-harm ER visits, cannabis co-diagnosis increased 90.1% (3.6 to 6.9/100,000) while alcohol declined 17.3%.

Perception of harm is strongly associated with complete ban on in-home cannabis smoking: a cross-sectional study.

Tripathi, Osika · 2024

Those who perceived secondhand cannabis smoke as "extremely harmful" had 6x higher odds of a complete home smoking ban (OR=6.0) compared to those rating it "totally safe." Even moderate harm perception ("somewhat harmful") was associated with 2.6x higher odds of a ban.

Polysubstance use during pregnancy: The importance of screening, patient education, and integrating a harm reduction perspective.

Board, Amy · 2023

In a nationally representative US sample, cigarettes (8.1%), alcohol (7.4%), and cannabis (4.3%) were the most commonly reported substances during pregnancy.

Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021.

Chambers, Julia · 2023

Among 5,035 US adults surveyed in 2017, 2020, and 2021, the perception that daily cannabis smoking is safer than tobacco increased from 36.7% to 44.3% (P<0.001).

Driving under the influence of cannabis, alcohol, and illicit drugs among adults in the United States from 2016 to 2020.

Myers, Matthew G · 2023

Using nationally representative NSDUH data, over 1 in 10 US adults reported DUI of any substance annually.

Impact of Prenatal Cannabis Use Disorder on Perinatal Outcomes.

Prewitt, Kristin C · 2023

Among 2,380,446 births, 9,144 (0.38%) had prenatal cannabis use disorder.

Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies

Theerasuwipakorn, Nonthikorn · 2023

As cannabis legalization expands globally, the cardiovascular safety question becomes increasingly urgent.

Cannabis-related emergency department visits by youths and their outcomes in Ontario: a trend analysis.

Bechard, Melanie · 2022

Cannabis-related ER visits rose from 3.8 per 10,000 youth in 2003 to 17.9 per 10,000 in 2017 (4.8-fold increase).

Linking in vitro and ex vivo CB1 activity with serum concentrations and clinical features in 5F-MDMB-PICA users to better understand SCRAs and their metabolites.

Janssens, Liesl K · 2022

Serum concentrations of 5F-MDMB-PICA correlated with ex vivo CB1 receptor activation in a sigmoidal relationship.

Cannabidiol (CBD) product contamination: Quantitative analysis of Δ9-tetrahydrocannabinol (Δ9-THC) concentrations found in commercially available CBD products.

Johnson, Erin · 2022

THC was detected above the quantification limit in 52 of 80 unregulated CBD products (65%).

Label accuracy of unregulated cannabidiol (CBD) products: measured concentration vs. label claim.

Johnson, Erin · 2022

Of 80 products, 37 (46%) contained CBD concentrations more than 10% different from label claims.

Textual and pictorial enhancement of cannabis warning labels: An Online experiment among at-risk U.S. young adults.

Kim, Sang Jung · 2022

Pictorially enhanced cannabis warning labels significantly improved recall accuracy (b = 0.59, p < 0.001) and perceived message effectiveness (b = 0.31, p = 0.008) compared to current California labels.

The Impact of Cannabis Packaging Characteristics on Perceptions and Intentions.

Kowitt, Sarah D · 2022

Edible gummies were perceived as healthier, less "grown up," and more socially acceptable than concentrates.

Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study.

Luke, Sabrina · 2022

Prenatal cannabis use (prevalence ~2%) was associated with increased risks of spontaneous preterm birth (aOR 1.80), medically indicated preterm birth (aOR 1.94), very preterm birth (aOR 1.73), low birth weight (aOR 1.90), small-for-gestational age (aOR 1.21), major congenital anomalies (aOR 1.71), cesarean section (aOR 1.13), and gestational diabetes (aOR 1.32).

Driving Performance and Cannabis Users' Perception of Safety: A Randomized Clinical Trial.

Marcotte, Thomas D · 2022

THC significantly impaired the Composite Drive Score at 30 minutes (d=0.59) and 1.5 hours (d=0.55), with borderline impairment at 3.5 hours (d=0.29) and no difference at 4.5 hours.

Trends in cannabis or cocaine-related dependence and alcohol/drug treatment in Argentina, Chile, and Uruguay.

Mauro, Pia M · 2022

Adjusted cannabis dependence increased from 0.7% to 1.5% in Argentina, 0.8% to 2.8% in Chile, and 1.4% to 2.4% in Uruguay.

Are blood and oral fluid Δ9-tetrahydrocannabinol (THC) and metabolite concentrations related to impairment? A meta-regression analysis.

McCartney, Danielle · 2022

Higher blood THC, 11-OH-THC, oral fluid THC, and subjective intoxication were associated with greater impairment in occasional users, but correlations were negligible to weak (r = -0.08 to -0.43).

Changes in Emergency Department Visits for Cannabis Hyperemesis Syndrome Following Recreational Cannabis Legalization and Subsequent Commercialization in Ontario, Canada.

Myran, Daniel Thomas · 2022

CHS ED visits increased from 0.26 to 3.43 per 100,000 population over 7.5 years (13-fold).

A national effectiveness trial of an eHealth program to prevent alcohol and cannabis misuse: responding to the replication crisis.

Newton, Nicola C · 2022

Students who received the Climate Schools program were 38% less likely to drink a full standard drink and 51% less likely to engage in heavy episodic drinking compared to controls at 12-month follow-up..

Longer-Term Efficacy of a Digital Life-Skills Training for Substance Use Prevention.

Paz Castro, Raquel · 2022

At 18 months, the intervention group had significantly lower cannabis prevalence (OR=0.55, 95% CI 0.39-0.76) and tobacco prevalence (OR=0.67, 95% CI 0.47-0.96) compared to controls.

Correlation between oral fluid and blood THC concentration: A systematic review and discussion of policy implications.

Robertson, M B · 2022

Oral fluid THC reliably detected presence of THC in blood (71.2% sensitivity, 97.7% specificity).

Local Education Agency Impact on School Environments to Reduce Health Risk Behaviors and Experiences Among High School Students.

Robin, Leah · 2022

Students in schools implementing the program had 11% lower odds of ever using marijuana (aOR=0.89, 95% CI 0.81-0.98) and 23% lower odds of current marijuana use (aOR=0.77, 95% CI 0.64-0.93).

Trends and characteristics of cannabis-associated emergency department visits in the United States, 2006-2018.

Roehler, Douglas R · 2022

Cannabis-associated ER visits increased from 12.3 to 34.7 per 100,000 from 2006-2014 (12.1% annual increase).

The effects of cannabis and alcohol on driving performance and driver behaviour: a systematic review and meta-analysis.

Simmons, Sarah M · 2022

Cannabis alone impaired lateral control (lane weaving) and decreased driving speed.

Cannabis use and risks of respiratory and all-cause morbidity and mortality: a population-based, data-linkage, cohort study.

Vozoris, Nicholas T · 2022

No significant difference in respiratory-related ER visits/hospitalizations between cannabis users and controls (OR 0.91, 95% CI 0.77-1.09).

Legal status of recreational cannabis and self-reported substitution of cannabis for opioids or prescription pain medication in Canada and the United States.

Wadsworth, Elle · 2022

Between 14-33% of cannabis consumers used it for pain.

Cannabis vaping among adults in the United States: Prevalence, trends, and association with high-risk behaviors and adverse respiratory conditions.

Boakye, Ellen · 2021

Cannabis vaping doubled nationally from 1.0% to 2.0% between 2017 and 2019, with the largest increase among young adults (1.2% to 3.9%).

Influence of package colour, branding and health warnings on appeal and perceived harm of cannabis products among respondents in Canada and the US.

Goodman, Samantha · 2021

Full branding was rated most appealing and plain packaging least (p<0.001).

Trends in cannabis use among adults with children in the home in the United States, 2004-2017: impact of state-level legalization for recreational and medical use.

Goodwin, Renee D · 2021

Recreational cannabis laws were associated with higher past-month use (AOR=1.28) and daily use (AOR=1.25) among adults with children.

Opioid use in medical cannabis authorization adult patients from 2013 to 2018: Alberta, Canada.

Lee, Cerina · 2021

Patients on high-dose opioids (OME > 100) who received medical cannabis authorization showed a significant decrease in opioid use of 435.5 mg OME over six months compared to matched controls..

Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study.

Lucas, Philippe · 2021

Among participants who used opioids at baseline (28%), the proportion dropped to 11% at six months.

Outcomes in patients with acute myocardial infarction and history of illicit drug use: a French nationwide analysis.

Ma, Iris · 2021

Among all illicit drugs evaluated, only cannabis use was significantly associated with higher AMI risk (HR 1.32, 95% CI 1.09-1.59).

Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI.

Blount, Benjamin C · 2020

Vitamin E acetate was detected in bronchoalveolar lavage fluid from 48 of 51 EVALI patients (94%) across 16 states but was absent in all 99 healthy comparators.

Odds of culpability associated with use of impairing drugs in injured drivers in Victoria, Australia.

Drummer, Olaf H · 2020

THC-positive drivers had modestly increased culpability odds (OR 1.9, 95% CI: 1.2-3.1).

International differences in patterns of cannabis use among adult cigarette smokers: Findings from the 2018 ITC Four Country Smoking and Vaping Survey.

Gravely, Shannon · 2020

Countries with more permissive cannabis regulations (Canada, US) had higher co-use rates and daily cannabis use among co-users.

Cannabis use, other drug use, and risk of subsequent acute care in primary care patients.

Matson, Theresa E · 2020

In a large prospective cohort, daily cannabis users had 24% higher risk of subsequent acute care (HR 1.24, CI 1.10-1.39) compared to non-users.

The Public Health Response to a Large Poisoning Outbreak Involving an Illicit Substance: Synthetic Cannabinoids Contaminated With a Long-Acting Anticoagulant Rodenticide, Illinois, March-July, 2018.

Navon, Livia · 2020

From March to July 2018, 174 confirmed and probable cases of severe coagulopathy (bleeding disorder) were identified among synthetic cannabinoid users in Illinois, including 5 deaths.

Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement From the American Heart Association.

Page, Robert L · 2020

The AHA scientific statement reviewed evidence that cannabis use is associated with cardiovascular risks including tachycardia, arrhythmias, myocardial infarction, stroke, and heart failure, many mediated by delivery mechanism (especially smoking).

Frequent Cannabis Use and Cessation of Injection of Opioids, Vancouver, Canada, 2005-2018.

Reddon, Hudson · 2020

Among three prospective cohorts of people who inject drugs (PWID) in Vancouver from 2005-2018, at-least-daily cannabis use was associated with 16% faster injection cessation overall (AHR 1.16, CI 1.03-1.30).

Healthcare cost associations of patients who use illicit drugs in Florida: a retrospective analysis.

Ryan, Jessica L · 2020

Across 709,658 drug-related healthcare observations in Florida (2016-2018), total costs were estimated at $6.4 billion.

Association of State Policies Allowing Medical Cannabis for Opioid Use Disorder With Dispensary Marketing for This Indication.

Shover, Chelsea L · 2020

Across 167 dispensary brands in 7 states, those in states where OUD is a qualifying condition had 39% more brands claiming cannabis treats OUD (p<0.001), 28% more claiming adjunctive therapy potential (p<0.001), 14% more recommending replacing FDA-approved OUD medications (p=0.002), and 25% more suggesting cannabis as an opioid substitute for pain (p=0.002) compared to adjacent states without this policy..

Pharmacokinetics of Cannabis Brownies: A Controlled Examination of Δ9-Tetrahydrocannabinol and Metabolites in Blood and Oral Fluid of Healthy Adult Males and Females.

Spindle, Tory R · 2020

After consuming cannabis brownies (0, 10, 25, or 50 mg THC), blood THC and 11-OH-THC peaked at 1.5-2 hours and returned to baseline within 8 hours.

Engaging Parents to Prevent Adolescent Substance Use: A Randomized Controlled Trial.

Bergman, Peter · 2019

By the end of 8th grade, lifetime use of alcohol or marijuana was 18.2% in the control group versus 10.2% in the intervention group (p=.02).

Cannabis use as a risk factor for causing motor vehicle crashes: a prospective study.

Brubacher, Jeffrey R · 2019

No increased crash risk in drivers with THC <2 or 2-5 ng/mL.

Alcohol and Cannabis Consumption Does Not Diminish Cure Rates in a Real-World Cohort of Chronic Hepatitis C Virus Infected Patients on Opioid Substitution Therapy-Data From the German Hepatitis C-Registry (DHC-R).

Christensen, Stefan · 2019

Cannabis use did not significantly influence SVR rates in either intention-to-treat or per-protocol analysis, regardless of opioid substitution therapy status.

Change in alcohol and other drug use during five years of continuous opioid substitution treatment.

Eastwood, Brian · 2019

Continued high-level heroin use during OST predicted continued high-level crack cocaine use (RRR 58.7), continued high-level alcohol use (RRR 1.2), and increasing unspecified drug use (RRR 1.7), but was associated with less high-and-increasing cannabis use (RRR 0.5)..

Did marijuana legalization in Washington State reduce racial disparities in adult marijuana arrests?

Firth, Caislin L · 2019

Among adults 21+, marijuana arrest rates dropped dramatically after legalization of possession and stayed low after retail market opening.

The impact of plain packaging and health warnings on consumer appeal of cannabis products.

Goodman, Samantha · 2019

Full branding was more appealing and more youth-oriented than plain packaging (p<0.001).

Public health implications of legalising the production and sale of cannabis for medicinal and recreational use.

Hall, Wayne · 2019

Cannabis legalisation has been associated with increased use in some populations and possible increases in road crashes.

Drivers who tested positive for cannabis in oral fluid: a longitudinal analysis of administrative data for Spain between 2011 and 2016.

Herrera-Gómez, Francisco · 2019

Of 65,244 confirmed drug-positive tests (2011-2016), 51,869 (79.5%) were THC-positive.

Acute Illness Associated With Cannabis Use, by Route of Exposure: An Observational Study.

Monte, Andrew A · 2019

Edible cannabis ER visits were disproportionate to sales (10.7% of visits vs 0.32% of THC sales).

Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019.

Perrine, Cria G · 2019

As of September 2019, 805 cases of vaping-associated lung injury were reported.

Risks and Benefits of Marijuana Use: A National Survey of U.S. Adults.

Keyhani, Salomeh · 2018

Researchers surveyed a probability-based sample of 16,280 U.S.

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review.

Sorensen, Cecilia J · 2017

This extensive systematic review analyzed 2,178 articles, ultimately including 183 studies with cumulative case data.

A systematic review of passive exposure to cannabis.

Berthet, Aurélie · 2016

This systematic review identified biomarkers that can distinguish passive cannabis smoke exposure from active use across multiple biological matrices. In everyday conditions, urinary THC-COOH levels from passive exposure should fall below standard positivity thresholds, especially when normalized to creatinine levels.

Independent Evaluation of Middle School-Based Drug Prevention Curricula: A Systematic Review.

Flynn, Anna B · 2015

Researchers conducted a systematic review specifically targeting independently evaluated randomized controlled trials of middle school drug prevention curricula.

Simultaneous versus concurrent use of alcohol and cannabis in the National Alcohol Survey.

Subbaraman, Meenakshi S · 2015

Simultaneous cannabis-alcohol users had 2.30x odds of drunk driving, 2.96x social consequences, and 2.22x harms to self vs alcohol-only users.

Synthetic cannabinoids: epidemiology, pharmacodynamics, and clinical implications.

Castaneto, Marisol S · 2014

This comprehensive review documented the rapid proliferation of synthetic cannabinoids (SC) as designer drugs since the early 2000s.

Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use: a randomized clustered trial.

Malmberg, Monique · 2014

Across all measures and both intervention conditions (e-learning and integral), the Healthy School and Drugs program showed no statistically significant effects on preventing new cases of alcohol, tobacco, or marijuana use at 32 months follow-up. The program was tested in two formats: an e-learning version (digital lessons only) and an integral version (digital lessons plus school policy and parental involvement).

Universal Internet-based prevention for alcohol and cannabis use reduces truancy, psychological distress and moral disengagement: a cluster randomised controlled trial.

Newton, Nicola C · 2014

Students who received the Internet-based Climate Schools: Alcohol and Cannabis course showed significant reductions in three key risk factors compared to controls.

Commentary--Project Towards No Drug Abuse: an evidence-based drug abuse prevention program.

Sussman, Steve · 2014

Project TND (Towards No Drug Abuse) was evaluated across seven group-randomized controlled trials.

"Unplugged," a European school-based program for substance use prevention among adolescents: overview of results from the EU-Dap trial.

Vigna-Taglianti, Federica D · 2014

The "Unplugged" program was evaluated in a randomized trial involving 7,079 students across seven European countries.

Evidence-based pharmacological treatment of substance use disorders and pathological gambling.

van den Brink, Wim · 2012

The review evaluated the evidence base for pharmacological treatments across multiple substance use disorders.

Cognition and motor control as a function of Delta9-THC concentration in serum and oral fluid: limits of impairment.

Ramaekers, J G · 2006

Twenty recreational cannabis users participated in a double-blind, placebo-controlled, three-way crossover study with single doses of 0, 250, and 500 micrograms/kg THC by smoking.

Cannabis modalities matter for momentary subjective drug effects.

Bedillion, Margaret F · 2026

Bong use was associated with greater 'good effects,' 'liking,' and 'willingness to take again' vs.

Evaluating cannabis substitution for alcohol within the context of a canadian managed alcohol program.

Goulet-Stock, Sybil · 2026

A significant between-person substitution effect was found: participants who used more cannabis on average also consumed less alcohol, with each additional 0.4g joint (approximately 76 mg THC) associated with 2.43 fewer mean daily standard drinks..

Alcohol quantity mediates the association between daily alcohol and cannabis co-use and alcohol consequences.

Gunn, Rachel L · 2026

Number of alcoholic drinks significantly mediated the association between co-use and consequences: co-use days involved more drinking, which drove higher negative consequences and lower positive consequences — suggesting alcohol quantity, not cannabis addition, is the key driver..

Authorization of storefront recreational cannabis retailers and cannabis-related healthcare encounters: A local-level spatial difference-in-differences analysis in California, United States.

Han, Bing · 2026

Analyzing cannabis-related healthcare encounters across all 482 cities in California from 2010 to 2020, researchers found that authorizing storefront recreational cannabis retailers was associated with increases in three types of healthcare encounters. Cities that permitted recreational dispensaries saw increases in population-adjusted emergency department visits, population-adjusted inpatient discharges, and the likelihood of poison center calls related to cannabis.

Therapeutic Use of Cannabis and Cannabinoids: A Review.

Hsu, Michael · 2026

Published in JAMA — the most widely read medical journal in the world — this review synthesized the therapeutic evidence for cannabis and cannabinoids across all conditions studied in randomized trials and meta-analyses. The strongest evidence supports three FDA-approved indications: HIV/AIDS-related anorexia (cannabinoids moderately increased body weight; SMD 0.57), chemotherapy-induced nausea and vomiting (small but significant reduction; SMD −0.29), and certain pediatric seizure disorders (CBD as Epidiolex). For chronic pain — the most common reason people report using medical cannabis — the review found that approximately 27% of US and Canadian adults have used cannabis medicinally, with 10.5% of the US population reporting CBD use for therapeutic purposes.

State cannabis and alcohol policy environments: Associations with college students' use of cannabis, alcohol and both substances.

Kerr, David C R · 2026

Drawing on survey data from over 900,000 college undergraduates (ages 18–24) across 591 four-year institutions in 47 states between 2008 and 2019, researchers examined how state-level cannabis and alcohol policy environments related to substance use patterns. Using a Cannabis Policy Scale (sum of 17 policies weighted by efficacy) and an Alcohol Policy Scale (29 policies), the analysis found that more restrictive cannabis policy environments were associated with significantly lower odds of any cannabis use (OR 0.97), frequent cannabis use (OR 0.93), and co-use of cannabis with binge drinking (OR 0.94).

Estimating thresholds for risk of cannabis use disorder using standard delta-9-tetrahydrocannabinol (THC) units.

Lees Thorne, Rachel · 2026

Weekly THC consumption discriminated CUD risk with good accuracy (AUC >0.70).

Clinical, physiological, imaging and molecular responses to cannabis smoking: the Canadian Users of Cannabis Smoke (CANUCK) study.

Leung, Clarus · 2026

The CANUCK study examined 139 cannabis smokers (categorized by joint-year exposure: low ≤5, moderate 5–20, high >20 joint-years) alongside 57 never-smokers, using an unusually comprehensive battery of tests. Cannabis smokers at all exposure levels reported worse respiratory symptoms than never-smokers.

Cannabis Use Among Individuals Treated with Medication for Opioid Use Disorder: Correlates, Patterns, and Motivations for Use.

Leyde, Sarah E · 2026

47.5% of MOUD patients used cannabis, 27% frequently (≥3 days/week).

Heterogeneity of Within-Day Simultaneous Alcohol and Cannabis Use Behaviors Among Young Adults: A Multilevel Latent Class Analysis.

Linden-Carmichael, Ashley N · 2026

Multilevel latent class analysis of 1,527 simultaneous use days identified four patterns: Alcohol-Focused (43%), Cannabis-Focused (35%), Heavy Use (14%), and Early-Day Use (8%).

Associations between cannabis use, cannabis use motivations and past year polysubstance use among people living with HIV in Florida.

McNeely, Kayla V · 2026

Cannabis use was associated with higher use of most other substances.

Disproportionate use of polysubstance combinations varies by sexual identity among US adults.

Mestre, Luis M · 2026

The most commonly used substances in polysubstance combinations were binge alcohol drinking, cannabis, cigarettes, and nicotine vaping.

A Latent Class Analysis of Polysubstance Use Patterns and Their Association with Ruminative Thinking Styles, Impulsivity-Like Traits, and Adverse Childhood Experiences Among College Students from Seven Countries.

Michelini, Yanina · 2026

Three substance use classes emerged: polysubstance users, alcohol-marijuana-tobacco co-users, and primarily drinkers.

Pass the Keys: Using Behavioral Economics to Explore Driving After Cannabis Use.

Miller, Brandon P · 2026

Cannabis demand (how much people would purchase and consume) was sensitive to driving latency: participants consumed more when driving was 6 hours away versus 20 minutes away.

Association of cannabis use disorder with postoperative complications following panniculectomy: a multicenter propensity-matched analysis.

Mokhtar, Jonathan · 2026

After propensity score matching on age, sex, BMI, race/ethnicity, and comorbidities, patients with CUD had significantly higher rates of postprocedural pain (RR 1.82, 95% CI 1.32-2.46, p < 0.001) and skin complications (RR 1.48, 95% CI 1.05-2.09, p = 0.019).

Clinical features and sociodemographic characteristics associated with analytically confirmed exposure to MDMB-4en-PINACA.

Moyns, Emma Jayne · 2026

Of 202 presentations involving 163 patients, 81.2% had reduced consciousness, 49% agitation, 30.2% seizures, and four died.

Joint Association of Methamphetamine and Cannabis Use as Risk Factors for Asthma Exacerbations Requiring Hospitalization: A Retrospective Analysis.

Musa, Amal M · 2026

Methamphetamine use alone showed a trend toward mechanical ventilation but was not significant.

Cannabis use before and after metabolic and bariatric surgery and its association with alcohol use.

Vanderziel, Alyssa · 2026

Post-bariatric surgery cannabis use rose from roughly 10.5% to 16%, a 52.4% relative increase.

Current marijuana use is cross-sectionally associated with accelerated biological aging among U.S. adults: exploring mediating effect of blood cadmium.

Wei, Kai · 2026

Current marijuana users showed significantly accelerated aging versus never users on both PhenoAge (beta = 0.72, p < 0.001) and KD-BioAge (beta = 0.36, p = 0.002).

Noncompliance with laws to prevent polysubstance misuse: Recreational cannabis sales to apparently alcohol-intoxicated customers.

Woodall, W Gill · 2026

Sellers were willing to sell cannabis to pseudo-intoxicated buyers at 73.7% of visits (255 of 346).

Prevalence, Patterns, and Correlates of Cannabis-Cigarette Co-Use: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023-2024.

Xue, Zheng · 2026

45% of current cigarette smokers reported concurrent cannabis use, compared to 24.5% of former smokers and 12.3% of never smokers.

Home Cultivation of Cannabis in a Context of Prohibition: Results from Two Online Cross-Sectional Surveys of People Using Cannabis Daily in France.

Bastien, Martin · 2025

Home cultivation was the main supply source for 11-16% of daily French cannabis users.

Prevalence of Impairing Substance Use in Injured Drivers.

Brubacher, Jeffrey R · 2025

This is one of the largest and most rigorous studies of substance use among injured drivers ever conducted.

Synthetic cannabinoids in e-cigarettes seized from English schools.

Cozier, Gyles E · 2025

Synthetic cannabinoids were detected in 17.4% of all e-cigarette samples seized from schools.

Outsmarting generic legislation: 4 years into the cat-and-mouse game of the synthetic cannabinoid receptor agonist market since the Chinese ban in 2021.

Deventer, Marie H · 2025

Ban-evading strategies included: alternative core structures (oxoindolins, oxopyridone, benzoate), linker replacement (acetamide instead of carboxamide), positional switching on conventional cores, adding or removing substituents (bromination, tail-less compounds), and a do-it-yourself synthesis approach where users convert legal tail-less precursors into banned potent SCRAs..

Cannabis-Associated Emergencies in the Emergency Department.

Eichhorn, David · 2025

In Canada after legalization, cannabis use among those 15+ rose from 15% to 25%, and hospital admissions doubled from 15 to 32 per 100,000.

Cannabidiol in Foods and Food Supplements: Evaluation of Health Risks and Health Claims.

Engeli, Barbara E · 2025

The lowest dose tested in humans that caused adverse effects (liver enzyme elevations) was 4.3 mg/kg/day, and this level can easily be reached by following the dosage recommendations on commercially available CBD oil products..

Patterns of substance use on a given day in a national sample of U.S. young adults.

Evans-Polce, Rebecca J · 2025

Six day-level patterns emerged: Vaping Nicotine (33.7%), Cannabis Smoking (23.5%), Alcohol Only (17.1%), Cannabis Vaping (11.7%), Multiple Combustibles (7.3%), and Multimodal Cannabis (6.7%).

Cannabis and Tobacco Co-Use and Cannabis Dependence: A Survey of US Adults in Legal Recreational Cannabis Markets.

Fairman, Brian J · 2025

Simultaneous and combined cannabis-tobacco co-use was associated with higher CUDIT-R scores compared to cannabis-only use, even after adjusting for demographics and use frequency.

The Cannabinoid System as a Potential Novel Target for Alcohol-Associated Liver Disease: A Propensity-Matched Cohort Study.

Fakhoury, Butros · 2025

Compared to non-cannabis users, those with CUD had a 40% lower ALD risk (HR 0.60), 17% lower decompensation risk (HR 0.83), and 14% lower mortality (HR 0.86).

Relationships Between Motives for Cannabis and Cannabidiol Use in People Who Co-Use: Results From the European Web Survey on Drugs.

Fortin, Davide · 2025

Among 35,789 cannabis users, 42.3% also used CBD.

Tracking metal presence in cannabis vaping products from source to inhalation.

Gajdosechova, Zuzana · 2025

Legal Canadian cannabis vape liquids contained metal particles (Al, Co, Cr, Cu, Ni, Sn, Zn) originating from device components.

Investigation of the toxic dose of ingested delta-8 tetrahydrocannabinol among young children.

Garay, Ryan S · 2025

Among 232 cases of young children who ingested delta-8 THC, those who consumed doses in the top quartile (above 17 mg/kg) had 3.4 times greater odds of severe toxicity and 5 times greater odds of prolonged toxicity.

Cannabis consumption patterns, adverse events, and cannabis risk beliefs: A latent profile analysis in WA State.

Garrett, Sharon B · 2025

Six user profiles ranged from weekly flower-only users to daily concentrate users.

Impact of Medications and Marijuana Use on Hyposalivation and Xerostomia in Adults.

Gehlken, Carter · 2025

Hyposalivation and xerostomia affected 44% of patients (705 of 1,600).

Prevalence of Cannabidiol (CBD) Use Among Patients Taking Medications with Known Drug-Drug Interactions: A Cross-Sectional Analysis.

Geneau, Hunter · 2025

Of 681 survey respondents, 254 (37.3%) reported CBD use in their household.

Cannabis use and its impact on respiratory physiology and lung cancer risk: Mechanistic and epidemiological insights (Review).

Georgakopoulou, Vasiliki Epameinondas · 2025

Cannabis smoke contains carcinogenic compounds similar to tobacco, and chronic smoking causes cough, sputum, and wheezing resembling chronic bronchitis.

Temporal Trends in Young Adult Cannabis and Tobacco Use in States with Different Cannabis Policies.

Glasser, Allison M · 2025

All states showed declining cigarette smoking, slight cigar declines, and increasing cannabis and blunt use among young adults.

Psychedelic risks and benefits: A cross-sectional survey study.

Goldy, Sean P · 2025

Psychedelic experiences had greater acute challenging effects and persisting negative effects compared to cannabis, but also greater positive acute and persisting effects.

Comparison of selected metals in the fillers of 14 commercial hemp cigarette brands to commercial tobacco cigarettes.

Gray, Naudia R · 2025

Researchers analyzed 14 commercial hemp cigarette brands for nine metals and compared them to published data on tobacco cigarettes and little cigars.

Simultaneous alcohol and cannabis use is associated with daily consequences reflective of alcohol use disorder symptoms.

Howe, Lindy K · 2025

Compared to simultaneous use (overlapping effects), concurrent use on the same day without overlapping effects was associated with 55% lower odds of impaired control, 53% lower odds of social impairment, 59% lower odds of risky use, and 64% lower odds of pharmacological effects.

Increasing trends of cannabinoid hyperemesis syndrome in youth: The grass is not always greener.

Jack, Benjamin · 2025

Using the Nationwide Emergency Room Sample, over 55,000 suspected CHS-related ED visits were identified among youth (ages 15-24) between 2006 and 2020, with an average annual increase of 28.1%.

Synthetic cannabinoid receptor agonists exacerbate fentanyl-elicited respiratory depression and confer resistance to naloxone rescue in mice.

James, Jared C · 2025

Co-administration of fentanyl with synthetic cannabinoids (JWH-018 or 5F-ADB-PINACA) exacerbated respiratory depression beyond either drug alone.

Cannabis Use in HIV: Impact on Inflammation, Immunity and the Microbiome.

Langat, Robert · 2025

Cannabis use in PWH was associated with reduced inflammatory biomarkers (MCP-1, IP-10), improved gut barrier integrity through increased SCFA production, increased gut mucosal immunity, decreased immune activation, and a unique microbiome composition.

Growing practices and the use of potentially harmful chemical additives from a web survey of mainly small-scale cannabis growers in 18 countries.

Lenton, Simon · 2025

In the 2020-21 survey, 26% of cannabis growers reported using chemicals.

In-hospital outcomes following an acute coronary syndrome in patients with recent cannabis use.

Léquipar, Antoine · 2025

Systematic urine screening across 39 French hospitals found 11.1% of acute coronary syndrome patients tested positive for cannabis.

Visual attention and memory retention of cannabis warning labels: an eye-tracking experiment with young adults.

Liu, Jiaying · 2025

Labels with specific text about health consequences held attention longer and improved risk recognition compared to generic warnings.

Associations Between Cannabis Messaging and Derived Psychoactive Cannabis Product Perceptions, Use, and Use Intentions Among a Sample of US Young Adults.

LoParco, Cassidy R · 2025

About 45.6% of cannabis users also used derived intoxicating cannabis products (DICPs).

Cannabis social equity initiatives among US states with legal non-medical cannabis retail: A review and recommendations.

LoParco, Cassidy R · 2025

Of 22 states with legal recreational cannabis sales, 17 had social equity licensing initiatives (13 reserved licenses for equity entrepreneurs).

Derived psychoactive cannabis product perceptions and use among a sample of US young adults.

LoParco, Cassidy R · 2025

DPCP awareness was 67.5% overall (87% among cannabis users vs 49% non-users).

Cannabis in the wild: Analysis of street cannabis and cannabinoid composition in Australia.

Lorenzetti, Valentina · 2025

One gram of Australian street cannabis contained an average of 34.8 mg THC (about 7 standard THC units) and 12% total THC with only 0.3% total CBD.

Cannabinoid Vaping Products: Regulation, Composition, Toxicological Effects, and Emerging Research.

Love, Charlotte A · 2025

Hemp-derived cannabinoid vaping products pose multiple respiratory risks: high cannabinoid concentrations, contaminants (heavy metals, flavoring agents), and harmful byproducts from heating.

Neighborhood Sociodemographic Correlates of Cannabis Dispensary Availability in States with Legalized Adult Recreational Use, United States, 2021.

Lowery, Bryce C · 2025

Census tracts with the highest percentage of Black residents had 2.07 times the odds of having a dispensary compared to those with the lowest.

Comparison of Perspectives on Cannabis Use Between Emergency Department Patients Who Are Users and Non-users.

Marco, Catherine A · 2025

Cannabis users scored 2.51/5 on negative short-term effects knowledge versus 3.28/5 for non-users (p = 0.004), and 1.78/5 on negative long-term effects versus 2.38/5 for non-users (p = 0.002).

Association of Substance Use with Types of Assault-Related Injury Among Black Men in Baltimore, Maryland.

Marineau, L A · 2025

Cannabis was the most frequently detected substance (42.5%), followed by alcohol (24.4%), opioids (22.3%), and cocaine (3.6%).

Levels of support and consumer perceptions of cannabis regulations in Canada.

Marquette, Anastasia · 2025

Support was highest for health warnings on products (62.6%), adult-use legalization (58.5%), and retail window coverings (49.2%).

Cannabis Use Characteristics and Reasons for Product Choices Among Patients Accessing Treatment for Substance Use Disorders: A Mixed-Methods Study.

Matheson, Justin · 2025

89% of current cannabis users smoked dried flower for non-medical purposes.

Substance Use Screening Among Adolescents: National Dental Practice-Based Research Network Survey.

McCauley, Jenna L · 2025

Fewer than half of dentists (40.5%) screened for adolescent nicotine/tobacco annually, with approximately one-third screening for cannabis and other substances.

A randomized, placebo-controlled, double-blind, pilot study of cannabis-related driving impairment assessed by driving simulator and self-report.

Meda, Shashwath A · 2025

In a controlled simulator study, cannabis administration led to measurable driving impairment including lane weaving and reaction time delays, even when participants self-reported feeling capable of driving..

Trends in Cannabis-Related Hospitalizations in Arizona From 2016 to 2021 and Associations With Mental Health-Related Hospitalizations.

Meier, Madeline H · 2025

Cannabis-related hospitalizations in Arizona increased notably over a six-year period that included the transition from medical-only to recreational cannabis legalization..

Trends and variations in admissions for cannabis use disorder among pregnant women in United States.

Mejia, Maria C · 2025

A retrospective analysis found rising rates of hospital admissions with cannabis use disorder diagnoses among pregnant women, suggesting growing prenatal cannabis use or improved diagnostic detection..

Cannabinoid Hyperemesis Syndrome Is Associated With High Disease Burden: An Internet-Based Survey.

Meltzer, Andrew C · 2025

Among 1,052 self-reported CHS sufferers, the majority reported frequent cannabis use and significant healthcare utilization including emergency department visits and hospitalizations.

Cannabis vape product advertising exposure is associated with cannabis vape product use and frequency among U.S. Young adults.

Meng, Siyan · 2025

Exposure to cannabis vape product (CVP) ads, higher frequency of ad exposure, and exposure across more advertising channels were all significantly associated with both CVP use and use frequency among 2,204 young adults.

In vitro pharmacological activity of twenty-eight synthetic cannabinoid receptor agonists at the type 1 and 2 cannabinoid receptors.

Mercier, Gabrielle · 2025

Twenty-eight synthetic cannabinoid receptor agonists were evaluated for receptor binding and signaling.

Current recommendations in the diagnosis and management of cannabinoid hyperemesis syndrome.

Meyer, Joshua · 2025

Beyond the traditional advice of complete THC cessation, current evidence supports using dopamine antagonists in acute CHS episodes, along with IV fluids, capsaicin cream, and standard antiemetics.

Substance use and mental health factors associated with self-reported higher risk cannabis use among people with HIV screened in primary care.

Mian, Maha N · 2025

Of 973 people with HIV, 35.9% screened positive for higher risk of cannabis use disorder.

Factors associated with cannabis use disorder among Australians using prescribed and illicitly-sourced medical cannabis.

Mills, Llewellyn · 2025

Among 1,796 medical cannabis users, 43% met any CUD criteria and 17% met moderate-severe CUD criteria.

Pictorial warning labels reduce sharing intentions, blunt self-relevance processes elicited by social media posts promoting cannabis edibles.

Minich, Matt · 2025

An online experiment (N=1,776) found cannabis warning labels reduced sharing intentions.

Trends in urine screening positive for cannabis of emergency department admissions in Israel 2016-2024.

Miron, Oren · 2025

Among 20,022 urine toxicology tests from Israeli ER admissions (2016-2024), cannabis-positive results increased modestly from 15.4% to 17.6%.

Association of Endothelial Dysfunction With Chronic Marijuana Smoking and THC-Edible Use.

Mohammadi, Leila · 2025

Among 55 participants, cannabis smokers had FMD of 6.0% and THC-edible users had 4.6%, both significantly lower than non-users at 10.4%.

Hexahydrocannabinol (HHC) use and harms in Ireland: New findings from the 2024 European Web Survey on Drugs.

Mongan, Deirdre · 2025

Hexahydrocannabinol (HHC)—a semi-synthetic cannabinoid marketed as a legal alternative to cannabis—was openly sold in Irish shops until it was banned in July 2025.

A Narrative Review of Research on Cannabis Advertising in the United States.

Moran, Meghan Bridgid · 2025

Cannabis is marketed through price promotions, storefront signage, social media, and billboards using tactics known to increase tobacco use.

The Role of Cannabis Policies and Perceptions of Penalties on the Association Between Adolescent Social Bonds and Cannabis Use.

Moscrop-Blake, Kelsi · 2025

Medical cannabis legalization was positively associated with past-year adolescent cannabis use.

Looking beyond traditional pain outcomes to better evaluate cannabis's true potential and limitations in chronic pain management.

Mun, Chung Jung · 2025

While clinical trials show inconsistent evidence for cannabis reducing pain severity, qualitative research reveals patients value cannabis because it changes their psychological response to pain and improves sleep, social functioning, and ability to reduce opioid use.

Cannabis concentrate vaping chemistry.

Munger, Kaelas R · 2025

Vaping cannabis concentrates (50%+ cannabinoid products) produces harmful aerosol toxicants including isoprene, 3-methylcrotonaldehyde, and other volatile compounds.

Measuring commercial cannabis availability: findings from a multi-state surveillance study in the US.

Nargis, Nigar · 2025

THC market size accounted for 90% or more of the combined cannabis market value across all 12 states regardless of legalization status.

Impact of Canada's Cannabis Act on drug- and alcohol-related collisions in Québec: an interrupted time-series analysis of five major cities.

Nazif-Munoz, José Ignacio · 2025

Total cannabis sales were significantly associated with a 12% increase in drug-related crashes (IRR 1.12) and a 12% increase in alcohol-related crashes (IRR 1.12) across five Quebec cities.

Rare but relevant: Cannabis use and myocardial infarction.

Padmanathan, Prianka · 2025

The link between cannabis use and myocardial infarction may be specific to certain types of cannabis, patterns of use, and user characteristics.

Characteristics and effects of cannabis advertisements with appeal to youth in California.

Padon, Alisa A · 2025

Several ad features significantly increased youth interest in cannabis: illustrations, clear product descriptions, food or flavor references, depictions of positive sensations, adventure imagery, psychoactive effects, and references to heavy consumption.

Cannabis product exposures reported to Ramathibodi Poison Center, Thailand, during 2018-2022.

Paisarnrodjanarat, Bootsakorn · 2025

Hospitalization rates increased significantly after each policy change: from 68.7% during the illegal period to 82% (medical), 91.5% (decriminalized), and 96.8% (recreational).

Patterns of cannabidiol use among marijuana users in the United States.

Park, Ji-Yeun · 2025

Current CBD use was 10.5% overall in the U.S.

Impact of Cannabis Use on Deep Inferior Epigastric Perforator Autologous Breast Reconstruction: analysis of 719 patients and 1148 flaps: Impact of Cannabis Use in DIEP Reconstruction.

Park, John B · 2025

Cannabis users (12.1% of the cohort) had significantly higher rates of postoperative hematoma (OR 3.078 for general hematoma, OR 3.098 for breast hematoma) and readmission (OR 2.865) after DIEP flap breast reconstruction.

Characterization of Patients With Symptoms of Gastroparesis Having Frequent Emergency Department Visits and Hospitalizations.

Parkman, Henry P · 2025

Cannabis use was independently associated with both ED visits and hospitalizations in gastroparesis patients, even after controlling for other factors.

Cannabis and psychosis: minimising harm while maximising therapeutic potential.

Patel, Rashmi · 2025

Cannabis use increases the risk of psychosis, but cannabis-based medicinal products may provide additional therapeutic opportunities.

Naturalistic investigation of cannabis strains varying in THC and CBD ratios and verbal recognition memory.

Paulich, Katie N · 2025

The idea that CBD might counteract THC's cognitive effects has been a popular hypothesis in cannabis research—and a selling point for balanced THC:CBD products.

Arrhythmias and cannabis use: A comprehensive overview.

Paulraj, Shweta · 2025

Epidemiological data show a significant association between cannabis use and various arrhythmias, particularly atrial fibrillation.

Marijuana policy and tribal communities in the United States.

Pedersen, Daphne E · 2025

Tribal communities face a uniquely complex cannabis policy landscape: tribes may legalize or criminalize cannabis independently but may be located within states with opposing policies.

Cannabinoid Hyperemesis Syndrome: A Rising Complication.

Peles, Saar · 2025

CHS is characterized by cyclical nausea, vomiting, and abdominal pain in chronic cannabis users, paradoxically caused by a drug known for anti-nausea effects.

Cannabis involvement in posttraumatic stress disorder emergency department visits after cannabis legalization.

Perrault-Sequeira, Laurent · 2025

Among 381,450 PTSD ED visits in Ontario, cannabis co-involvement increased by 151% (from 0.13 to 0.33 per 100,000) between the first and last cannabis policy periods, while alcohol co-involvement increased by 58%.

Changes in blood cannabinoid concentrations over multiple collection times in driving under the influence of drugs casework.

Peterson, Brianna L · 2025

In 35 DUID cases with multiple blood draws (81 total samples), THC concentrations ranged from 0.74 to 40 ng/mL.

Cannabinoid Hyperemesis Syndrome in Adolescents: A Narrative Review.

Pietrantoni, Camilla · 2025

CHS is increasingly being diagnosed in adolescents despite limited data in the pediatric population.

Cannabis use among adults who smoke tobacco: Relations with switching from combusted cigarettes to e-cigarettes or very low nicotine cigarettes.

Piper, Megan E · 2025

Participants who reported past-30-day cannabis co-use (N=56) smoked significantly more usual brand cigarettes during switch weeks than non-co-users (N=104, p=0.03) and were less likely to make a tobacco cessation attempt (p<0.05).

Trends in cannabis adverse reaction reports: A descriptive analysis of spontaneous reporting data submitted to the Canada Vigilance Program since legalization and regulation of cannabis for non-medical purposes in Canada.

Plebon-Huff, Sieara · 2025

Among 698 adverse reaction reports to the Canada Vigilance Program, the average reporting individual was 56 years old, 45.4% were female, and 67.5% reported medical use (mainly pain management).

Harm reduction strategies for cannabis-related problems: a literature review and typology.

Pratschke, Jonathan · 2025

From a systematic review of 35 documents published 2011-2022, the authors developed a typology of cannabis harm reduction strategies covering three domains: legal interventions (regulatory approaches), socio-organizational interventions (community and institutional measures), and health-related interventions (clinical and public health approaches).

Cannabis Use in Adolescents.

Rabinow, Lily · 2025

Despite increasing adult cannabis use and higher-THC products, longitudinal studies show less than 20% of youth report current cannabis use and lifetime use has actually decreased over recent decades.

Evaluation of iSTART: A Novel Substance Use Prevention Web-App Designed for Diverse College Students.

Rainisch, Bethany K W · 2025

Among 1,066 students randomly assigned to a web-app intervention, comparison, or control condition, those in the 5-module web-app group had significantly greater substance knowledge gains, more accurate peer use perceptions, and better understanding of health risks than comparison or control students.

Recommendations for the Clinical Management and Prevention of Pediatric Cannabis Edible Ingestions.

Ricchezza, Joseph · 2025

Cannabis edible products pose significant health risks to children due to inconsistent governmental regulation of manufacturing, packaging, and labeling.

Product Characteristics, Warnings, and Marketing Appeals Conveyed on Delta-8 THC Product Packaging in the US and Canada.

Robichaud, Meagan O · 2025

Analysis of 140 delta-8 THC products from the US and Canada found that only 32.9% displayed any health warning, and warnings appeared on the front of packaging just 11.7% of the time.

Patient experiences and perspectives regarding medicinal cannabis: a qualitative scoping review.

Rosenbæk, Frederik · 2025

Three major themes emerged: patients described therapeutic potential and tolerability across various conditions, used diverse administration methods tailored to individual needs, but faced significant barriers including stigma, high costs, and bureaucratic delays.

Patients' perceived benefit and side effects from the use of medicinal cannabis - a cross-sectional survey study from Denmark.

Rosenbæk, Frederik · 2025

Among 1,044 Danish medical cannabis users, 67% reported moderate to large perceived benefit.

Help-seeking behaviours among cannabis consumers in Canada and the United States: Findings from the international cannabis policy study.

Rundle, Samantha M · 2025

Among 13,209 past-12-month cannabis consumers, only 9.2% sought help in the past 3 months.

Cannabis and liver transplant in the era of legalization: Effects of pretransplant cannabis use on postoperative opioid use and transplant outcomes.

Runge, Ava · 2025

Among 4,236 patients, cannabis users required significantly more opioids in the 48 hours after transplant (p=0.04).

Inhaled Cannabis, Asthma, and Chronic Obstructive Pulmonary Disease: A Population-Based Cross-Sectional Study of n = 379,049.

Rustagi, Alison S · 2025

Daily inhaled cannabis was associated with higher odds of asthma (aOR 1.44) and COPD (aOR 1.27) after adjusting for tobacco use.

Evaluating risks, monitoring cannabis use, and planning to get home safely: Exploring self-regulation processes associated with cannabis use and driving.

Sukhawathanakul, Paweena · 2025

Cannabis users showed substantial heterogeneity in self-regulation processes related to driving.

Understanding Suicidal Thoughts and Behaviors Among LGBTQ + Youth: Differential Associations Between Bullying and Substance Use.

Tiedge, Cayson W · 2025

Bullied LGBTQ+ youth had 2.71 times higher odds of planning suicide attempts.

Motives for Cannabis Use and Readiness to Change Among Users of the "Stop-Cannabis" Mobile App: Cluster Analysis.

Wegener, Milena · 2025

Analysis of Stop-Cannabis app profiles revealed distinct subgroups based on cannabis use motives and readiness to change.

Brief report: Are changes in cannabis use frequency associated with changes in alcohol use and smoking among people with HIV (PWH) - A substitution question.

Whitney, Bridget M · 2025

Among people with HIV, increasing cannabis use (initiation or increased frequency) was not associated with subsequent decreases in alcohol or tobacco use.

Delta-8 tetrahydrocannabinol, delta-10 tetrahydrocannabinol, and tetrahydrocannabinol-O acetate exposures reported to America's Poison Centers.

Burgess, Alice · 2024

There were 5,022 reported cases from 2021-2022, with the rate per 100,000 population increasing 89.1% (from 0.55 to 1.04).

Cannabis use and dependence among festival attendees: results from the French OCTOPUS survey.

Chaaban, Sarah · 2024

63.4% of regular cannabis users (at least monthly) at music festivals met DSM-IV dependence criteria.

Effect of a selective personality-targeted prevention program on 7-year illicit substance related outcomes: A secondary analysis of a cluster randomized controlled trial.

Champion, Katrina E · 2024

The PreVenture group had 22% lower odds of annual cannabis-related harms compared to controls (OR=0.78, 95% CI: 0.65-0.92).

Risk of motor vehicle collision associated with cannabis and alcohol use among patients presenting for emergency care.

Choo, Esther K · 2024

Cannabis alone was not associated with higher MVC odds.

Droperidol Plus Diphenhydramine for Symptom Improvement in Suspected Cannabinoid Hyperemesis Syndrome: A Prospective Cohort Study.

Chopra, Quincy · 2024

Nausea/vomiting VAS scores dropped from 8.3 at baseline to 3.1 at 30 minutes and 1.4 at 120 minutes (both p<0.05).

Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case-control study from Thailand.

Chumchuen, Kemmapon · 2024

After adjusting for covariates, smoking and sharing a cannabis bong had an odds ratio of 4.22 (95% CI: 1.47-12.07) for TB.

Secondhand cannabis smoke exposure and respiratory symptoms among adults living in a state with legalized medical cannabis with limited smoke-free protections.

Cohn, Amy M · 2024

SHCS exposure was reported by 42% of adults.

The impacts of packaging on preferences for cannabis edibles: A discrete choice experiment.

Cooper, Michael · 2024

Nearly all groups preferred branded over plain packages and any health claim over none.

Digital Interventions for Recreational Cannabis Use Among Young Adults: Systematic Review, Meta-Analysis, and Behavior Change Technique Analysis of Randomized Controlled Studies.

Côté, José · 2024

Digital interventions reduced cannabis use frequency by 6.79 days in the previous month at 3-month follow-up (95% CI: -9.59 to -4.00, p<.001) compared to controls.

Illicit Cannabis Use to Self-Treat Chronic Health Conditions in the United Kingdom: Cross-Sectional Study.

Erridge, Simon · 2024

Among 10,965 weighted respondents, 5,700 (52%) reported chronic health conditions, and 364 (6.38%) of those purchased illicit cannabis for self-treatment.

Prevalence of cannabis use and the frequency, types, and sources of cannabis products used in northern remote territories of the Canadian legal cannabis market.

Hobin, Erin · 2024

Past 12-month cannabis use was reported by 46.1% of respondents, with 21.8% reporting daily or near-daily use.

Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder.

Kudrich, Christopher · 2024

CBD has become wildly popular, with claims ranging from anxiety relief to pain management.

Adverse outcomes of cannabis use in Canada, before and after legalisation of non-medical cannabis: cross-sectional analysis of the International Cannabis Policy Study.

Marquette, Anastasia · 2024

Approximately one-third of cannabis users reported at least one adverse event in the past year, and 5% sought medical help.

Rising Inpatient Utilization and Costs of Cannabis Hyperemesis Syndrome Hospitalizations in Massachusetts After Cannabis Legalization.

Marshall, Allison · 2024

CHS hospitalizations rose from 0.02% to 0.1% of total admissions after legalization.

Exploring the effects of cannabis health warnings on protective health intentions among US adults in legal recreational states.

Massey, Zachary B · 2024

Among 1,095 cannabis users, attention to warnings increased cognitive elaboration, fear, and hope.

Cannabinoid Hyperemesis Syndrome (CHS) - An emerging gastrointestinal disorder and clinical challenge.

McFee, R B · 2024

CHS is characterized by cyclic, severe vomiting, compulsive hot showering, and chronic cannabis use history.

Regulatory Landscape of Cannabis Warning Labels in US States with Legal Retail Nonmedical Cannabis, 2024.

Meek, Caroline J · 2024

Among 20 states with legal retail cannabis, only 2 required mental health risk warnings and 2 required high-potency psychosis warnings.

Assessment of education in a community hospital on healthcare providers' knowledge of and attitudes toward medical marijuana.

Meyers, Sierra · 2024

All four provider groups showed significant post-education knowledge improvements: physicians (P<.01), nurses (P<.001), pharmacists (P<.01), and nurse technicians (P<.05).

Surgery-Related Considerations in Treating People Who Use Cannabis: A Review.

Mims, Mark M · 2024

Cannabis users may require higher anesthesia doses due to tolerance, face increased rates of myocardial ischemia, and experience prolonged sedation.

Cannabis Use and Associated Risk Behavior Factors among High School Students in Mississippi: Youth Risk Behavior Surveillance System 2021.

Mitra, Amal K · 2024

In multivariable analysis adjusting for gender, race, grade, and other risk behaviors, cannabis use was significantly associated with current electronic vaping, current tobacco smoking, current alcohol drinking, and sexual behaviors.

Cannabis Use Is Associated With Increased Use of Prescription Opioids Following Posterior Lumbar Spinal Fusion Surgery.

Moon, Andrew S · 2024

Among 220 opioid-naive patients, 29 cannabis users consumed significantly more postoperative prescription opioids (2,545 vs 1,380 morphine equivalent doses, p=.019) than 191 non-users.

The impact of recreational cannabis legalization on ED visit rates for acute cannabis intoxication.

Nguyen, An · 2024

After Michigan legalized recreational cannabis in December 2018, cannabis-related ED visits increased significantly (unadjusted RR 1.70; age-adjusted RR 1.47).

Cannabinoid hyperemesis syndrome: prevalence and management in an era of cannabis legalization.

Stubbs, Justin Joe · 2024

CHS typically presents with episodic vomiting from chronic daily cannabis use over months to years, with nausea and abdominal pain improved by hot showers.

Clearing the air: Heightened perception of harm from secondhand cannabis smoke exposure is associated with no in-home cannabis smoking in a 21-country convenience sample.

Tripathi, Osika · 2024

Those at the 75th percentile (vs 25th) of perceived harm from secondhand cannabis smoke had 70% higher odds (OR=1.7) of reporting no in-home cannabis smoking.

In-Home Cannabis Smoking Among a Cannabis-Using Convenience Sample from the Global Drug Survey: With Weighted Estimates for U.S. Respondents.

Tripathi, Osika · 2024

Among international cannabis users, any in-home smoking was reported by 63.9% of men, 61.9% of women, and 68.6% of nonbinary people.

Exploring the substitution of cannabis for alcohol and other drugs among a large convenience sample of people who use cannabis.

Wilkins, Chris · 2024

Sixty percent reported cannabis use led to less alcohol use, 60% to less synthetic cannabinoid use, 44% to less morphine use, and 40% to less methamphetamine use.

Recreational marijuana laws and the misuse of prescription opioids: Evidence from National Survey on Drug Use and Health microdata.

Ali, Mir M · 2023

Standard difference-in-differences analysis suggested RML adoption reduced frequent opioid misuse.

Relationships between sales of legal medical cannabis and alcohol in Canada.

Armstrong, Michael J · 2023

Using fixed effect panel data regressions controlling for retail activity, alcohol prices, education levels, unemployment, and impaired driving penalties, each dollar of legal medical cannabis sold was associated with a $0.74-$0.84 decrease in alcohol sales.

Dispensary Staff Perceptions About the Benefits, Risks, and Safety of Cannabis for Medical Purposes.

Bulls, Hailey W · 2023

Among 434 dispensary staff from 29 states, over 80% viewed cannabis as helpful for PTSD (88.7%), epilepsy (85.3%), and cancer (83.4%).

Severe outcomes following pediatric cannabis intoxication: a prospective cohort study of an international toxicology surveillance registry.

Cohen, Neta · 2023

Of 138 pediatric patients presenting with cannabis intoxication, 52 (38%) were admitted to ICU including one death.

Toxicity of Synthetic Cannabinoids in K2/Spice: A Systematic Review.

de Oliveira, Mariana Campello · 2023

Across 64 studies (10 original papers and 54 case studies), synthetic cannabinoid use was associated with severe toxicity including death (14 studies), with AB-CHMINACA and MDMB-CHMICA most commonly involved in fatalities.

Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization.

Myran, Daniel T · 2023

Annual rates of cannabis-involved traffic injury ER visits rose from 0.18 to 1.01 per 1,000 total motor vehicle collisions.

Acute care related to cannabis use during pregnancy after the legalization of nonmedical cannabis in Ontario.

Myran, Daniel Thomas · 2023

The mean quarterly rate of cannabis-related acute care during pregnancy rose from 11.0 to 20.0 per 100,000 pregnancies after legalization (IRR 1.82).

Evaluating the Supporting Evidence of Medical Cannabis Claims Made on Clinic Websites: Cross-Sectional Study.

O'Neill, Braden · 2023

Twenty-nine cannabis clinics in Ontario promoted cannabis for 20 different medical indications including migraines, insomnia, and fibromyalgia.

Medicinal Cannabis and Implications for Workplace Health and Safety: Scoping Review of Systematic Reviews.

O'Neill, Veronica · 2023

Across 31 systematic reviews and meta-analyses, the most predominant adverse events of medical cannabis were sedation, nausea/vomiting, dizziness, and euphoria.

Drug-impaired driving and traffic collisions: Study on a cross section of the Italian population.

Odoardi, Sara · 2023

Among 1,236 drivers in crashes, alcohol was most common (19% non-fatal, 32% fatal), followed by cannabinoids (12% non-fatal) and cocaine (9% non-fatal, 20% fatal).

Co-use of cigarettes and cannabis among people with HIV: Results from a randomized controlled smoking cessation trial.

Ozga, Jenny E · 2023

Increased cannabis use was associated with reduced odds of cigarette abstinence at 6 months vs decreased use (aOR 0.22) or no use (aOR 0.25).

Clinical characteristics and long-term outcomes in patients with cyclic vomiting syndrome: A 15-year experience at a tertiary referral center.

Partovi, Omeed · 2023

Episodes dropped from 18 to 6.8/year, ER visits from 6.1 to 2, hospitalizations from 2.3 to 0.7.

Safety assessment and redox status in rats after chronic exposure to cannabidiol and cannabigerol.

Polanska, Hana Holcova · 2023

CBD (0.66 mg/kg/day for 90 days) produced no changes in blood counts or biochemistry and improved redox status in blood plasma and liver, reducing malondialdehyde and carbonylated proteins.

Recreational cannabis and opioid distribution.

Raman, Shyam · 2023

Using two-way fixed-effects regressions across 11 states that adopted recreational cannabis laws between 2010 and 2019, the study found RCLs led to a reduction in codeine dispensed at retail pharmacies.

Cannabis use to manage opioid cravings among people who use unregulated opioids during a drug toxicity crisis.

Reddon, Hudson · 2023

Cannabis use to manage opioid cravings was reported by 57.6% of participants and was significantly associated with self-reported opioid reduction (aOR=2.13, 95% CI: 1.07-4.27).

Cessation of self-reported opioid use and impacts on co-occurring health conditions.

Scheidell, Joy D · 2023

Ceasing opioid use was associated with no longer reporting cannabis use (aOR=1.82, 95% CI: 1.10-3.03), cessation of cocaine use (aOR=1.93, 95% CI: 1.16-3.20), improvements in pain (aOR=1.53, 95% CI: 1.05-2.24), and improvements in anxiety (aOR=1.56, 95% CI: 1.01-2.41).

Location and home rules of cannabis use - Findings from marijuana use and environmental survey 2020, a nationally representative survey in the United States.

Tripathi, Osika · 2023

Cannabis was most commonly used at home, and many households lacked rules restricting indoor cannabis use.

Effects of Smoking Marijuana on the Respiratory System: A Systematic Review.

Vásconez-González, Jorge · 2023

Marijuana smoking exposes lungs to combustion byproducts that cause airway inflammation, chronic bronchitis symptoms, and possible emphysematous changes.

Differentiating Diabetic Ketoacidosis and Hyperglycemic Ketosis Due to Cannabis Hyperemesis Syndrome in Adults With Type 1 Diabetes.

Akturk, Halis Kaan · 2022

Cannabis users had dramatically different lab profiles than non-users: pH 7.42 vs.

In-home cannabis smoking more prevalent than in-home tobacco smoking among 2019 Global Drug Survey respondents.

Bellettiere, John · 2022

Among cannabis-only users, 78.8% reported past-year in-home cannabis smoking, compared to 67.9% of tobacco-only users smoking tobacco at home.

Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates.

Bonnet, Udo · 2022

Users and experts produced similar overall harm rankings, both placing heroin, cocaine, and amphetamines at the top and cannabis, psychotropic mushrooms, and buprenorphine near the bottom.

Pharmacological management of cannabinoid hyperemesis syndrome: an update of the clinical literature.

Burillo-Putze, Guillermo · 2022

CHS does not reliably respond to standard IV antiemetics.

Cannabis hyperemesis syndrome: Incidence and treatment with topical capsaicin.

Burillo-Putze, Guillermo · 2022

Across 59 ED visits from 29 patients, CHS incidence was 4.4 per 10,000 visits.

Are vaporizers a lower-risk alternative to smoking cannabis?

Chaiton, Michael · 2022

Cannabis vaporizers reduce carbon monoxide emission, chronic respiratory symptoms, and exposure to several toxins while producing similar subjective effects and blood THC concentrations compared to smoking.

Correlates of behavior change intents in response to a hypothetical flavored cigar sales restriction among U.S. adult flavored cigar smokers.

Chen-Sankey, Julia · 2022

In response to a hypothetical flavored cigar sales restriction, 15.1% would quit cigars, 41.6% would smoke plain cigars, 33.4% would switch to other flavored tobacco, and 29.2% would substitute cannabis.

Road traffic injury risk from alcohol and cannabis use among emergency department patients in Argentina.

Conde, Karina · 2022

Alcohol use increased road traffic injury risk 6.78-fold (95% CI 3.75-12.25).

Effectiveness of a neuroscience-based, harm reduction program for older adolescents: A cluster randomised controlled trial of the Illicit Project.

Debenham, Jennifer · 2022

Students who received the Illicit Project program were significantly less likely than controls to engage in weekly binge drinking (OR 0.56), early cannabis use (OR 0.35), risky cannabis use (OR 0.48), MDMA use (OR 0.16), and nicotine use (OR 0.59).

Public Health Implications of Cannabis Legalization: An Exploration of Adolescent Use and Evidence-Based Interventions.

Donnelly, Joseph · 2022

As of June 2021, 36 states had medical cannabis laws and 17 had recreational laws.

Prevalence and factors associated with self-reported exposure to secondhand cannabis smoke in the United States and Canada in 2019.

Driezen, Pete · 2022

Monthly secondhand cannabis smoke exposure at home was reported by 16.9% in Canada, 20.6% in U.S.

Combined effect of alcohol and cannabis on simulated driving.

Fares, Andrew · 2022

The combination of alcohol (target BAC 0.08%) and cannabis (12.5% THC) significantly increased standard deviation of lateral position (weaving) compared to placebo and to either drug alone.

Randomized controlled trial of motivational interviewing for alcohol and cannabis use within a predominantly Hispanic adolescent sample.

Feldstein Ewing, Sarah · 2022

In 448 adolescents (347 Hispanic, 101 non-Hispanic white, ages 13-18), those receiving motivational interviewing showed greater reductions in alcohol use compared to alcohol and cannabis education (ACE) at 6 months.

Effects of cannabidiol in cannabis flower: Implications for harm reduction.

Gibson, Laurel P · 2022

Among 159 regular cannabis users randomly assigned to three chemovars, the THC+CBD chemovar (9% THC, 10% CBD) produced similar positive mood effects but significantly less paranoia and anxiety compared to the THC-dominant chemovar (24% THC, 1% CBD).

Identification of ∆9-tetrahydrocannabinol (THC) impairment using functional brain imaging.

Gilman, Jodi M · 2022

In 169 cannabis users given oral THC or placebo in a crossover design, prefrontal cortex oxygenated hemoglobin increased after THC only in participants classified as impaired.

Association of medical cannabis licensure with prescription opioid receipt: A population-based, individual-level retrospective cohort study.

Goedel, William C · 2022

Among 5,296 medical cannabis license holders in Rhode Island, licensure was not associated with changes in odds of filling any opioid prescription (OR 0.99), filling prescriptions at 50+ morphine equivalent dose (OR 0.93), or at 90+ MED (OR 0.99).

Perceptions of the health risks of cannabis: estimates from national surveys in Canada and the United States, 2018-2019.

Goodman, Samantha · 2022

Knowledge of cannabis health risks was highest for driving impairment (66-80%), pregnancy risks (61-71%), and addiction potential (51-62%), but lowest for psychosis and schizophrenia risk (23-37%).

Do Mandatory Health Warning Labels on Consumer Products Increase Recall of the Health Risks of Cannabis?

Goodman, Samantha · 2022

Free recall of at least one warning message increased from 5% (pre-legalization) to 15% in Canada post-legalization, significantly outpacing U.S.

Guideline No. 425b: Cannabis Use Throughout Women's Lifespans - Part 2: Pregnancy, the Postnatal Period, and Breastfeeding.

Graves, Lisa E · 2022

Based on GRADE-assessed evidence, the guideline recommends avoiding cannabis during pregnancy and breastfeeding, or reducing use as much as possible if abstaining is not feasible.

Association between secondhand marijuana smoke and respiratory infections in children.

Johnson, Adam B · 2022

Caregivers who used marijuana reported an increased rate of viral respiratory infections in their children (1.31 episodes/year) compared to non-users (1.04 episodes/year, p=0.02).

Marijuana and the Lung: Evolving Understandings.

Joshi, Manish · 2022

Marijuana can cause bronchitis symptoms.

Ask Your Provider About Cannabis: Increasing Nurse Practitioner Knowledge and Confidence.

Klein, Tracy A · 2022

Significant improvement in all content areas from pre- to post-test, with a mean improvement of 39.3%.

Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting.

Klimas, Jan · 2022

22% of illicit opioid users reported substituting at least once during the study.

Cannabis Use and Parenting Practices among Young People: The Impact of Parenting Styles, Parental Cannabis-Specific Rules, and Parental Cannabis Use.

Kokotovič, Karmen Osterc · 2022

Parental cannabis use was the strongest predictor of youth cannabis use.

The Effects of Cannabinoids on Sleep.

Kolla, Bhanu Prakash · 2022

Cannabis products have minimal to no effects on sleep disorders and may have deleterious effects in some individuals.

Cannabis smoking and glaucoma in the UK Biobank cohort.

Lehrer, S · 2022

Heavy cannabis users (100+ times) were diagnosed with glaucoma approximately 10 years earlier than never-users.

Marijuana smoking and cataract.

Lehrer, S · 2022

Cannabis users (11-100 times) were diagnosed with cataracts 4-5 years earlier than non-users.

Marijuana and Myocardial Infarction in the UK Biobank Cohort.

Lehrer, Steven · 2022

Multivariate logistic regression found marijuana use associated with reduced MI risk (OR 0.844), comparable to red wine consumption (OR 0.847).

Characteristics of Adults Who Use Both Marijuana and E-Cigarette, or Vaping, Products: A Cross-Sectional Study, Utah, 2018.

Lewis, Nathaniel M · 2022

Dual users of marijuana and e-cigarettes had dramatically higher odds of being aged 18-29 (aOR 12.44), being male (aOR 3.29), reporting 14+ days of poor mental health (aOR 2.30), having asthma (aOR 2.09), COPD (aOR 2.94), currently smoking cigarettes (aOR 4.56), and using prescribed pain medications (aOR 2.13)..

Edible marijuana products and potential risks for pediatric populations.

Lin, Allison · 2022

Edible marijuana products are indistinguishable from normal foods, lack the smell associated with smoked cannabis, have delayed onset that predisposes to overconsumption, and feature packaging intentionally similar to mainstream food brands, increasing accidental ingestion risk..

Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes.

Lo, Jamie O · 2022

THC crosses the placenta and has been detected in breast milk.

Paediatric cannabinoid hyperemesis.

Lonsdale, Hannah · 2022

Current best evidence recommends IV rehydration and electrolyte correction, followed by haloperidol 0.05 mg/kg with or without a benzodiazepine for acute pediatric CHS.

Fourth Generation of Synthetic Cannabinoid Receptor Agonists: A Review on the Latest Insights.

Malaca, Sara · 2022

Fourth-generation synthetic cannabinoid receptor agonists have increased CB1 receptor affinity and efficacy compared to previous generations, leading to more potent psychoactive effects and increased adverse reactions including psychosis, hallucinations, self-harm, tachycardia, and deaths..

Orally administered cannabidiol does not produce false-positive tests for Δ9 -tetrahydrocannabinol on the Securetec DrugWipe® 5S or Dräger DrugTest® 5000.

McCartney, Danielle · 2022

Among 259 DrugWipe 5S and 256 DrugTest 5000 tests following oral CBD administration (placebo, 15, 300, or 1,500 mg), no THC-positive results were observed.

Influence of cannabis use history on the impact of acute cannabis smoking on simulated driving performance during a distraction task.

Miller, Ryan · 2022

Occasional cannabis users (1-2 times/week) had significantly increased lane departure risk during distraction after acute cannabis use (OR=3.71, P=0.04).

Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition.

Mills, Llewellyn · 2022

CUD criteria were met by 32% (any-CUD) and 12.9% (moderate-severe CUD) of medical cannabis users.

Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa.

Mona, Khanya · 2022

Current cannabis use was 48.9% and lifetime use 51.1%.

Adulteration of low-delta-9-tetrahydrocannabinol products with synthetic cannabinoids: Results from drug checking services.

Monti, Manuela Carla · 2022

Of 94 samples, 50% contained up to three different synthetic cannabinoids, with MDMB-4en-PINACA most common.

Fetal Exposure to Cannabis and Childhood Metabolic Outcomes: The Healthy Start Study.

Moore, Brianna F · 2022

Approximately 15% of mothers had detectable cannabinoids in urine at ~27 weeks gestation.

A Content Analysis of Cannabis Company Adherence to Marketing Requirements in Four States.

Moreno, Megan A · 2022

Among 2,660 posts from 14 recreational cannabis businesses on Facebook and Instagram, discounts and promotions (restricted content) appeared in approximately 35% of posts and overconsumption messaging in 12%.

The Link Between Cannabis Use and Violent Behavior in the Early Phase of Psychosis: The Potential Role of Impulsivity.

Moulin, Valerie · 2022

Cannabis use is particularly high in early-phase psychosis (EPP) and is a confirmed risk factor for violent behavior in this population.

The prevalence and pattern of cannabis use among patients attending a methadone treatment clinic in Nairobi, Kenya.

Ngarachu, Elizabeth Wambui · 2022

Cannabis prevalence was 85.8% at baseline and 62.7% during follow-up among methadone patients.

QTc prolongation in cannabis hyperemesis syndrome patients exposed to antiemetics: A retrospective chart review.

Noelle, Carrillo · 2022

No significant differences in post-medication QTc values were found between different anti-emetic drugs used to treat CHS.

Trends in cannabis-related attitudes and behaviors among cannabis-using adolescent and young adult outpatients following medical cannabis legalization in Massachusetts.

O'Connell, Maddie · 2022

Use of diverted medical cannabis increased from 15% in 2013 to 44% in 2016 (adjusted OR 4.66, 95% CI 1.81-11.95).

Early-Onset Cardiovascular Disease From Cocaine, Amphetamines, Alcohol, and Marijuana.

O'Keefe, Evan L · 2022

All four substances (cocaine, amphetamines, alcohol, marijuana) are cardiotoxic and contribute to rising levels of premature cardiovascular disease including hypertension, arrhythmias, heart failure, stroke, myocardial infarction, and sudden cardiac death in younger populations..

Comparison of the effects of alcohol and cannabis on visual function and driving performance. Does the visual impairment affect driving?

Ortiz-Peregrina, Sonia · 2022

Both alcohol (300 ml and 450 ml wine) and cannabis significantly impaired visual function scores.

Measuring PM2.5 concentrations from secondhand tobacco vs. marijuana smoke in 9 rooms of a detached 2-story house.

Ott, Wayne R · 2022

A marijuana joint produced average 5-hour PM2.5 concentrations of 38.9-80.7 mcg/m3 across three experiments, compared to 15.0-15.2 mcg/m3 for a tobacco cigarette.

Cannabis and the heart: unchartered territory.

Parikh, Kinna · 2022

Cannabis has been linked to acute myocardial infarction in young, otherwise healthy individuals; atherogenesis acceleration; cardiac arrhythmias; Takotsubo (stress) cardiomyopathy; and cannabis arteritis.

Endocannabinoid system and cannabis hyperemesis syndrome: a narrative update.

Perisetti, Abhilash · 2022

The endocannabinoid system produces biphasic effects: acute cannabis use is antiemetic, but chronic heavy use can trigger a proemetic response leading to CHS.

Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai'i who use cannabis: A matched cohort study.

Phillips, Kristina T · 2022

Cannabis-diagnosed patients had significantly greater risk of coronary heart disease, chronic non-cancer pain, stroke, myocardial infarction, cyclic vomiting, and injuries compared to age- and sex-matched controls.

Current state of cannabis use, policies, and research across sixteen countries: cross-country comparisons and international perspectives.

Ransing, Ramdas · 2022

Cannabis use prevalence reporting was inconsistent across countries.

Cannabinoid hyperemesis syndrome and cannabis withdrawal syndrome: a review of the management of cannabis-related syndrome in the emergency department.

Razban, Mohammad · 2022

CHS and CWS both present with abdominal pain and vomiting but arise from different pathophysiology.

Cannabinoid hyperemesis syndrome: A 6-year audit of adult presentations to an urban district hospital.

Rotella, Joe A · 2022

142 presentations from 67 unique patients.

Getting high for likes: Exploring cannabis-related content on TikTok.

Rutherford, Brienna N · 2022

54.14% of videos portrayed cannabis positively (417 million total views).

Cannabis Adaptation During and After Alcohol Ignition Interlock Device Installation: A Longitudinal Study.

Scherer, Michael · 2022

Among 189 DUI-convicted drivers, those who decreased alcohol use while an ignition interlock device was installed significantly increased cannabis use, which continued to rise after the device was removed..

A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options.

Senderovich, Helen · 2022

Cannabis cessation is the most successful management for CHS.

Evaluating cannabis use risk reduction as an alternative clinical outcome for cannabis use disorder.

Sherman, Brian J · 2022

Cannabis risk levels based on frequency and quantity were sensitive to reductions in use.

Urinary Excretion Profile of Cannabinoid Analytes Following Acute Administration of Oral and Vaporized Cannabis in Infrequent Cannabis Users.

Sholler, Dennis J · 2022

Using federal workplace drug-testing criteria (50 ng/mL screening, 15 ng/mL confirmation), urine specimens tested positive for THC-COOH in 97.6% of oral cannabis sessions versus 59.5% of vaporized sessions at active THC doses..

Simultaneous use of marijuana and alcohol: Potential prevention targets among young adults who use alcohol.

Skinner, Martie L · 2022

Marijuana-specific attitudes (believing it is not wrong for their age) differentiated simultaneous or co-users from alcohol-only users.

Relation of Cannabis Use to Elevated Atherosclerotic Cardiovascular Disease Risk Score.

Skipina, Travis M · 2022

Ever cannabis use was associated with 60% increased odds of a high-risk ASCVD score.

The phytochemical diversity of commercial Cannabis in the United States.

Smith, Christiana J · 2022

Distinct chemical phenotypes (chemotypes) were reliably present across commercial cannabis samples, but commercial labels (strain names, indica/sativa designations) did not consistently align with the observed chemical diversity, though certain labels showed biased associations with specific chemotypes..

Tobacco/nicotine use among individuals using cannabis for therapeutic purposes.

Steinberg, Marc L · 2022

39.3% of medical cannabis patients reported current nicotine use, higher than the general population.

Presence of Content Appealing to Youth on Cannabis-Infused Edibles Packaging.

Tan, Andy S L · 2022

15% of packages resembled product knockoffs (e.g., candy brands), 23% contained human/non-human creatures, 35% had flavor images, and 91% had flavor text.

Inhaled Marijuana and the Lung.

Tashkin, Donald P · 2022

Smoking marijuana produces short-term bronchodilation in healthy subjects and asthmatics.

Psychotomimetic symptoms after a moderate dose of a synthetic cannabinoid (JWH-018): implications for psychosis.

Theunissen, Eef L · 2022

JWH-018 (average dose 5.52 mg) caused psychedelic effects (altered internal and external perception), dissociative effects (amnesia, derealization, depersonalization), and confusion in healthy participants with no history of mental illness..

Assessment of dependence potential and abuse liability of Δ8-tetrahydrocannabinol in mice.

Vanegas, S O · 2022

Delta-8-THC produced cannabimimetic effects (catalepsy, antinociception, hypothermia, immobility) at doses above 12.5 mg/kg, all blocked by the CB1 antagonist rimonabant.

Cannabis use is associated with lower retention in methadone maintenance treatment, but not among schizophrenic- and other chronically psychotic patients.

Volkov, Ilan · 2022

Cannabis-using methadone patients had significantly shorter cumulative retention (6.0 years) than non-users (9.1 years).

Consumer perceptions of legal cannabis products in Canada, 2019-2021: a repeat cross-sectional study.

Wadsworth, Elle · 2022

By 2021, consumers perceived legal cannabis as safer to buy (54%), more convenient (47.8%), but more expensive (47.2%) than illegal cannabis.

Content Analysis of the Corporate Social Responsibility Practices of 9 Major Cannabis Companies in Canada and the US.

Wakefield, Tanner · 2022

Nine major cannabis companies engaged in CSR activities that encouraged increased consumption and targeted marginalized communities.

Interests and concerns regarding medical marijuana among chronic pain patients in Ohio: an online survey.

Adams, Daniel · 2021

84.3% were willing to consider medical marijuana.

Trend differences over 20 years between two methadone maintenance clinics, one with and one without cannabis legalization.

Adelson, Miriam · 2021

The Las Vegas clinic (1,724 patients) had lower one-year retention than Tel Aviv (1,014 patients): 46.4% vs.

Young and under the influence: A systematic literature review of the impact of cannabis on the driving performance of youth.

Alvarez, Liliana · 2021

Class II evidence suggests THC is likely to reduce mean speed, headway distance, and reaction time, and increase lane and steering wheel position variability in young drivers.

Toxicological aspects of cannabinoid, pesticide and metal levels detected in light Cannabis inflorescences grown in Italy.

Amendola, G · 2021

Among 31 light cannabis inflorescence samples, THC was always below 0.5% and CBD ranged from 0.3-8.64%.

An Examination of Risk Factors for Tobacco and Cannabis Smoke Exposure in Adolescents Using an Epigenetic Biomarker.

Andersen, Allan · 2021

Increasing proportions of students tested positive for cotinine (5-16%), THC (3-10%), and the epigenetic biomarker (5-7%) from 10th to 12th grade.

Increased Testing and Health Care Costs for Pediatric Cannabis Exposures.

Bashqoy, Ferras · 2021

Children with unrecognized cannabis exposure underwent an average of 8.91 diagnostic tests compared to 4 for those where exposure was quickly identified, with more than 4-fold higher costs for potentially avoidable tests.

Cannabis, alcohol and other drug findings in fatally injured drivers in Ontario.

Beirness, Douglas J · 2021

Among 921 driver fatalities, 53.7% tested positive for at least one substance.

The importance of psychology for shaping legal cannabis regulation.

Borodovsky, Jacob T · 2021

Cannabis regulations should account for three key agents: consumers (whose behavior is driven by pharmacological and environmental variables), the cannabis industry (which uses marketing strategies that may increase harm), and regulatory agencies (which can use evidence from psychology to shape consumption patterns)..

Adverse events of recreational cannabis use reported to the French addictovigilance network (2012-2017).

Bouquet, Emilie · 2021

Cannabis adverse event reports tripled from 179 (2012) to 562 (2017), totaling 2,217 cases.

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses.

Breijyeh, Zeinab · 2021

Established medical uses include chronic pain, chemotherapy nausea, appetite stimulation, MS spasticity, and epilepsy.

Pharmacological and Toxicological Effects of Phytocannabinoids and Recreational Synthetic Cannabinoids: Increasing Risk of Public Health.

Bukke, Vidyasagar Naik · 2021

207 synthetic cannabinoid compounds were identified by the EMCDDA from 2008 to 2020.

Sex differences in cannabis forms and exposure reasons in cannabis-related poison control center cases aged 50.

Choi, Namkee G · 2021

Women over 50 had 1.93 times greater odds of calling about therapeutic errors/adverse reactions compared to intentional misuse.

Cannabis and synthetic cannabinoid poison control center cases among adults aged 50+, 2009-2019.

Choi, Namkee G · 2021

Cases increased 18-fold (61 to 1,074) over the decade.

Pharmacology and adverse effects of new psychoactive substances: synthetic cannabinoid receptor agonists.

Chung, Eun Yong · 2021

SCRAs are the most commonly abused new psychoactive substances worldwide.

Pediatric Cannabis Single-Substance Exposures Reported to the Michigan Poison Center From 2008-2019 After Medical Marijuana Legalization.

Dean, Diana · 2021

426 pediatric cannabis exposures were reported to the Michigan Poison Center from 2008 to 2019.

Trends and Characteristics of Manufactured Cannabis Product and Cannabis Plant Product Exposures Reported to US Poison Control Centers, 2017-2019.

Dilley, Julia A · 2021

The study documented increasing cannabis exposure reports to US poison control centers from 2017 to 2019, with distinct patterns for manufactured cannabis products versus plant materials in terms of patient demographics and clinical characteristics..

A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents.

Donaldson, Candice D · 2021

In Study 1 (N=808), at-risk adolescents who perceived cannabis use as normative showed lowest usage intentions after receiving a tailored gain-framed message.

Recreational cannabis laws and opioid-related emergency department visit rates.

Drake, Coleman · 2021

Event study models using ED data from 29 states (2011-2017) found recreational cannabis laws reduced opioid-related ED visit rates by approximately 7.6% for two quarters after implementation.

Trends and Factors Related to Blunt Use in Middle and High School Students, 2010-2020.

Ebrahimi Kalan, Mohammad · 2021

Past and current blunt use declined from 2010 to 2015 (APC = -5.32% and -5.28%), but current use increased from 2015 to 2018 (APC = 14.91%) before leveling off.

Lethal coagulopathy resulting from the consumption of contaminated synthetic cannabinoids: the story of a public health crisis.

Fasih, Anum · 2021

The outbreak affected 174 reported patients and caused 5 deaths.

Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes.

Gimelli, Alex · 2021

14.5% reported cannabis use in their home in the prior six months.

Is Cannabis being used as a substitute for non-medical opioids by adults with problem substance use in the United States? A within-person analysis.

Gorfinkel, Lauren R · 2021

On days when cannabis was used, the adjusted odds of non-medical opioid use were 1.86 times higher (95% CI: 1.44-2.41).

Communicating THC levels and 'dose' to consumers: Implications for product labelling and packaging of cannabis products in regulated markets.

Hammond, David · 2021

The review identified that consumers struggle with numeric THC information (mg vs.

Association between perceived risk of harm and self-reported binge drinking, cigarette smoking, and marijuana smoking in young adults.

Hanauer, Matthew · 2021

Students who perceived high risk of harm from marijuana smoking were significantly less likely to report using it.

Are marijuana-using caregivers being asked about their marijuana use by their child's pediatrician?

Johnson, Adam B · 2021

Of 1,500 caregivers surveyed, 167 (11%) reported using marijuana.

Efficacy of topical capsaicin for cannabinoid hyperemesis syndrome in a pediatric and adult emergency department.

Kum, Vivian · 2021

A significantly greater proportion of patients receiving capsaicin achieved efficacy (55% vs.

Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample.

Kvamme, Sinikka L · 2021

Of 2,841 respondents using cannabis medically (91% non-prescribed), 54.6% used it to replace a prescription drug.

Perioperative Pain and Addiction Interdisciplinary Network (PAIN): consensus recommendations for perioperative management of cannabis and cannabinoid-based medicine users by a modified Delphi process.

Ladha, Karim S · 2021

Major consensus recommendations included: elicit and quantify cannabis use history, contact the cannabis authorizer if one exists, consider perioperative cannabis weaning, provide additional postoperative nausea/vomiting prophylaxis, pay extra attention to anesthetic depth monitoring, anticipate increased postoperative analgesic requirements, and watch for cannabis withdrawal syndrome..

The efficacy of health warnings and package branding on perceptions of cannabis products among youth and young adults.

Leos-Toro, Cesar · 2021

Presence of brand imagery on cannabis packaging significantly increased appeal ratings among 16-30 year olds, while health warning labels significantly decreased appeal.

Self-reported reductions in tobacco and nicotine use following medical cannabis initiation: Results from a cross-sectional survey of authorized medical cannabis patients in Canada.

Lucas, Philippe · 2021

Of 650 current or former tobacco/nicotine users, 320 (49%) self-reported reductions in use after initiating medical cannabis, with 160 (24.6%) reporting no tobacco/nicotine use in the prior 30 days.

Tetrahydrocannabinol and Skin Cancer: Analysis of YouTube Videos.

Mamo, Andrina · 2021

All 10 videos received the lowest possible Global Quality Scale score (1 = poor quality).

Analysis of State Cannabis Laws and Dispensary Staff Recommendations to Adults Purchasing Medical Cannabis.

Merlin, Jessica S · 2021

Most dispensary staff based recommendations on the customer's medical condition (74%), other customers' experiences (70%), the customer's prior experience (67%), and personal experience (63%).

Use of Cannabis for Harm Reduction Among People at High Risk for Overdose in Vancouver, Canada (2016-2018).

Mok, Janice · 2021

About 1 in 4 participants used cannabis for harm reduction during the study period.

A Digital Health Tool to Understand and Prevent Cannabis-Impaired Driving Among Youth: A Cross-sectional Study of Responses to a Brief Intervention for Cannabis Use.

Moreno, Georgina · 2021

Every 10-point increase in ASSIST score increased the probability of sometimes driving after cannabis use by 7.3%.

Intoxicated driving and riding with impaired drivers: Comparing days with alcohol, marijuana, and simultaneous use.

Patrick, Megan E · 2021

On simultaneous alcohol-marijuana days, odds of riding with an impaired driver were 1.28x higher than alcohol-only days and 2.22x higher than marijuana-only days.

Interventions to Prevent Drugged Driving: A Systematic Review.

Razaghizad, Amir · 2021

Cannabis packaging with health warnings increases knowledge about drugged driving effects (high certainty).

The association between cannabis use and outcome in pharmacological treatment for opioid use disorder.

Rosic, Tea · 2021

Any cannabis use vs non-use was not associated with opioid use during treatment (OR 1.03, 95% CI 0.87-1.23).

Reported Marijuana and Tobacco Smoke Incursions Among Families Living in Multiunit Housing in New York City.

Sangmo, Lodoe · 2021

Among 382 surveyed families, 30.9% reported marijuana smoke incursions while home with their child, with NYCHA (public housing) residents 3.45 times more likely to report exposure compared to other housing types..

Cannabis use is associated with reduced risk of exposure to fentanyl among people on opioid agonist therapy during a community-wide overdose crisis.

Socías, M Eugenia · 2021

In a prospective cohort of 819 participants on opioid agonist therapy (OAT) contributing 1,989 observations (2016-2018), cannabis use (detected by urine testing) was independently associated with a 9% reduced likelihood of fentanyl exposure (adjusted prevalence ratio=0.91, 95% CI: 0.83-0.99)..

VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history.

Tolou-Shams, Marina · 2021

Girls randomized to VOICES reported significantly less cannabis use over 9-month follow-up compared to the control condition (p<0.01).

The state of the evidence on the association between state cannabis laws and opioid-related outcomes: A review.

Tormohlen, Kayla N · 2021

Across 21 U.S.

The synthetic cannabinoids phenomenon: from structure to toxicological properties. A review.

Alves, Vera L · 2020

Synthetic cannabinoids are the largest NPS class with 190 substances reported to the EU Early Warning System (2008-2018) and ~280 reported worldwide.

Concomitant Substance Use Increases the Toxic Effect of synthetic cannabinoid (Bonsai): A Prospective Study.

Beydilli, İnan · 2020

69.4% of patients had concomitant drug intake.

A lottery test of the effect of dispensaries on emergency room visits in Arizona.

Conyers, Gregory · 2020

Zip codes winning a dispensary license saw cannabis-related ER visits increase approximately 45% relative to non-winning zip codes over four years.

Characteristics and circumstances of synthetic cannabinoid-related death.

Darke, Shane · 2020

Causes of death: accidental toxicity (38.2%), natural disease (20%), suicide (10.9%), accidental toxicity with CVD (9.1%), traumatic accident (10.9%).

Evaluation of Pesticides Found in Oregon Cannabis from 2016 to 2017.

Evoy, Richard · 2020

Both recreational and medicinal cannabis products contained high pesticide levels, with 50 different pesticides identified.

Post-Mortem Toxicology: A Systematic Review of Death Cases Involving Synthetic Cannabinoid Receptor Agonists.

Giorgetti, Arianna · 2020

No reliable toxic or lethal concentration ranges have been established for synthetic cannabinoids.

Investigation of DNA damage, oxidative stress, and inflammation in synthetic cannabinoid users.

Guler, E M · 2020

Synthetic cannabinoid users had significantly higher DNA damage, plasma oxidant status, myeloperoxidase activity, and inflammatory markers (IL-1-beta, IL-6, TNF-alpha).

The costs and benefits of cannabis control policies
.

Hall, Wayne · 2020

Cannabis policy entails unavoidable trade-offs: prohibition reduces use but creates criminal justice harms; depenalization reduces enforcement costs with minimal impact on use rates; medical legalization may increase adult use; and recreational legalization paired with commercialization is likely to increase use based on patterns from alcohol, tobacco, and gambling industries..

E-cigarette or vaping product use-associated lung injury.

Ind, Philip W · 2020

EVALI presented primarily in young men as severe lung consolidation with respiratory failure.

Critical Illness Secondary to Synthetic Cannabinoid Ingestion.

Kourouni, Ismini · 2020

Over two years, 30 patients were admitted to the ICU after synthetic cannabinoid use.

The relationship between cannabis use and patient outcomes in medication-based treatment of opioid use disorder: A systematic review.

Lake, Stephanie · 2020

Across 41 studies examining cannabis use during methadone, buprenorphine, or naltrexone treatment for opioid use disorder, the majority found no significant association between cannabis use and opioid use, treatment adherence, or retention.

Self-reported Cannabis Use and Changes in Body Mass Index, CD4 T-Cell Counts, and HIV-1 RNA Suppression in Treated Persons with HIV.

Lee, James T · 2020

In a retrospective cohort of 1,010 HIV-positive adults starting their first ART regimen (4,290 visits, 2008-2011), cannabis use was associated with greater odds of detectable viral load (OR 2.02 for ever-use during study, OR 1.72 for any use in past 7 days).

Reductions in alcohol use following medical cannabis initiation: results from a large cross-sectional survey of medical cannabis patients in Canada.

Lucas, Philippe · 2020

In a survey of 2,102 Canadian medical cannabis patients, 973 who regularly drank alcohol reported that after starting medical cannabis, 44% decreased drinking frequency, 34% reduced drinks per week, and 8% stopped drinking entirely.

Marijuana: the effects on pregnancy, the fetus, and the newborn.

Martin, Gilbert I · 2020

The review summarizes evidence that prenatal cannabis exposure is associated with lower birth weight, neonatal effects, and developmental delays during the first two years of life.

Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review.

Okusanya, Babasola O · 2020

Across 9 studies involving 7,222 participants, combining medical cannabis with opioids was associated with 64-75% reduction in opioid dosage for non-cancer chronic pain.

Marijuana use and acute myocardial infarction: A systematic review of published cases in the literature.

Patel, Rikinkumar S · 2020

Across 46 published studies describing 62 patients who had acute myocardial infarction following marijuana use, the mean age was 27.7 years with male predominance.

Perceptions of U.S. and Canadian Cannabis Package Warnings Among U.S. Adults.

Pepper, Jessica K · 2020

Among 1,000 US adults (500 cannabis users, 500 tobacco-using non-cannabis users), the psychosis warning was rated most educational and most frequently selected as best for discouraging youth use.

Cannabis hyperemesis syndrome: an update on the pathophysiology and management.

Perisetti, Abhilash · 2020

CHS is characterized by cyclic nausea and vomiting worsened by cannabis, with compulsive hot bathing/showers for relief.

Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study.

Safakish, Ramin · 2020

Among 751 chronic pain patients initiating medical cannabis treatment, pain severity and interference improved significantly at 1 month and remained improved through 12 months (p<0.001).

Self-reported exposure to, perceptions about, and attitudes about public marijuana smoking among US adults, 2018.

Schauer, Gillian L · 2020

Among 4,088 US adults surveyed in 2018, 27.4% reported marijuana secondhand smoke (SHS) exposure in the past week in indoor and/or outdoor public areas.

The switch from one substance-of-abuse to another: illicit drug substitution behaviors in a sample of high-risk drug users.

Shapira, Barak · 2020

448 of 592 high-risk drug users (75.7%) reported substituting their preferred drug.

Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users.

Shapira, Barak · 2020

Of 342 patients in drug dependence treatment, 16.1% reported past-12-month synthetic cannabinoid receptor agonist (SCRA) use and 24.9% reported recent prescription opioid or fentanyl patch use.

Why do patients come to the emergency department after using cannabis?

Shelton, Shelby K · 2020

Of all ED visits with cannabis ICD-CM codes, detailed chart review determined only 25.74% were at least partially attributable to cannabis.

Cannabinoid1 (CB-1) receptor antagonists: a molecular approach to treating acute cannabinoid overdose.

Skolnick, Phil · 2020

Cannabis legalization has dramatically increased ED visits and hospitalizations for acute cannabis overdose, with edibles and synthetic cannabinoids responsible for disproportionate share.

Cannabis and synthetic cannabinoid exposure reported to the Israel poison information center: Examining differences in exposures to medical and recreational compounds.

Sznitman, Sharon R · 2020

Of 615 cannabinoid poisoning cases, 55% were recreational cannabis, 33% synthetic cannabinoids, and 12% medical cannabis.

A Survey on the Effect That Medical Cannabis Has on Prescription Opioid Medication Usage for the Treatment of Chronic Pain at Three Medical Cannabis Practice Sites.

Takakuwa, Kevin M · 2020

Of 525 chronic pain patients who used both medical cannabis and prescribed opioids, 40.4% stopped all opioids, 45.2% decreased use, 13.3% had no change, and only 1.1% increased opioid use.

Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014-2015.

Thrul, Johannes · 2020

48.6% smoked cigarettes only.

Patterns of Cannabis Use in Patients With Cyclic Vomiting Syndrome.

Venkatesan, Thangam · 2020

41% of CVS patients used cannabis, with 21% using regularly (4+ times/week).

A systematic review and Bayesian meta-analysis of interventions which target or assess co-use of tobacco and cannabis in single- or multi-substance interventions.

Walsh, Hannah · 2020

Meta-analysis of 11 RCTs (up to 1,117 participants) showed weak evidence for cannabis cessation (RR=1.48, CrI 0.92-2.49) and no clear effect on tobacco cessation (RR=1.10, CrI 0.68-1.87).

Marijuana exposures in Colorado, reported to regional poison centre, 2000-2018.

Wang, George Sam · 2020

Total marijuana exposures increased by 11.2 cases per year overall (p<0.0001) but remained stable from 2014-2017 (p=0.22), with a 19.4% increase in 2018 vs.

Cigarette smoking quit ratios among adults in the USA with cannabis use and cannabis use disorders, 2002-2016.

Weinberger, Andrea H · 2020

In 2016, quit ratios were 23% for any cannabis users and 15% for those with CUD, versus 51% for non-cannabis users and 48% for those without CUD.

The association between regular cannabis use, with and without tobacco co-use, and adverse cardiovascular outcomes: cannabis may have a greater impact in non-tobacco smokers.

Winhusen, Theresa · 2020

In the total sample and non-tobacco subgroup, regular cannabis use was significantly associated with greater risk for stroke (CVA), arrhythmia, subarachnoid hemorrhage (SAH), and all-cause mortality.

Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes.

Zeiger, Joanna S · 2020

Three attitude clusters emerged: Conservative (32.2%), Unsure (45.9%), and Liberal (21.9%).

Implementing social justice in the transition from illicit to legal cannabis.

Adinoff, Bryon · 2019

Progress in five social justice areas: expungement of prior convictions (some progress, especially misdemeanors), cannabis-related arrests in legal environments (decreased), industry diversity (very limited), equity program funding (very limited), and risk of legalization harming previously targeted populations (no evidence of increased harm)..

Review of the many faces of synthetic cannabinoid toxicities.

Alipour, Azita · 2019

Synthetic cannabinoids produced a wide range of severe toxicities including arrhythmias, myocardial infarction, sudden cardiac death, psychosis, suicidal ideation, seizures, acute tubular necrosis, and intracranial hemorrhage.

Use of Cannabis to Relieve Pain and Promote Sleep by Customers at an Adult Use Dispensary.

Bachhuber, Marcus · 2019

65% of adult-use customers used cannabis for pain relief, and 74% used it for sleep.

Synthetic cannabinoid-associated coagulopathy secondary to long-acting anticoagulant rodenticides: Observational case series and management recommendations.

Bahouth, Mona N · 2019

Hematuria was the most common bleeding symptom.

Overview of "home" cultivation policies and the case for community-based cannabis supply.

Belackova, Vendula · 2019

At least 27 jurisdictions have adopted non-prohibitive approaches to home cannabis cultivation, ranging from full legalization to de facto depenalization.

Cannabinoid toxicity in pediatrics.

Blohm, Eike · 2019

Young children hospitalized for cannabis toxicity are increasingly exposed to high-concentration products (edibles, resins, vaping fluid) containing extremely high cannabinoid levels, leading to sedation, respiratory depression, and other adverse effects.

Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users With Chronic Pain.

Boehnke, Kevin F · 2019

80% of 1,321 medical cannabis users with chronic pain reported substituting cannabis for traditional pain medications: 53% for opioids, 22% for benzodiazepines.

Implementation and Effectiveness of an Online Responsible Vendor Training Program for Recreational Marijuana Stores in Colorado, Oregon, and Washington State.

Buller, David B · 2019

Among 420 trained employees, ID checking ability improved significantly (pre: 3.91 to post: 4.58, p<.001), as did confidence to use inventory tracking (pre: 2.52 to post: 2.85, p<.001) and to spot intoxicated customers (pre: 2.79 to post: 2.94, p<.001).

New trends in cannabis potency in USA and Europe during the last decade (2008-2017).

Chandra, Suman · 2019

Picking up where ElSohly's earlier analysis left off, this study tracked another decade of cannabis potency data from the University of Mississippi's monitoring program.

Cannabis-Associated Asthma and Allergies.

Chatkin, J M · 2019

Multiple studies associate marijuana use with increased asthma symptoms and other allergic disease manifestations, as well as increased frequency of medical visits.

Cannabis-related emergencies in children and teens.

Chen, Yih-Chieh · 2019

Cannabis-related pediatric ED visits are rising with changing legislation.

Prevalence of Involuntary Environmental Cannabis and Tobacco Smoke Exposure in Multi-Unit Housing.

Chu, Alanna K · 2019

Among multi-unit housing residents in Ontario, 7.5% reported environmental cannabis smoke (ECS) exposure and 6.6% reported environmental tobacco smoke (ETS) exposure from neighboring units.

Positive and Negative Effects of Cannabis and Cannabinoids on Health.

Cohen, Koby · 2019

Repeated cannabis use is associated with respiratory and cardiovascular disorders, cognitive alterations, psychosis, schizophrenia, and mood disorders.

Adverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only.

De Aquino, Joao P · 2019

Veterans with co-occurring OUD and CUD received fewer opioid prescriptions (mean 3.79 vs 4.8) compared to the OUD-only group, but had a higher likelihood of inpatient psychiatric admission (RR = 1.95) and homelessness (RR = 1.52)..

Cannabinoid hyperemesis syndrome: a review of the literature.

Deceuninck, Eleonore · 2019

CHS manifests as incoercible cyclical vomiting, diffuse abdominal pain, and compulsive hot showering in chronic cannabis users.

Exploring the Diagnosis and Profile of Cannabis Allergy.

Decuyper, Ine Ilona · 2019

Can s 3-based diagnostic tests showed the best combination of predictive values (80% positive, 60% negative) for confirming cannabis allergy.

In-hospital outcomes of inflammatory bowel disease in cannabis users: a nationwide propensity-matched analysis in the United States.

Desai, Rupak · 2019

In Crohn's disease, cannabis users had lower rates of colorectal cancer (0.3% vs 1.2%), parenteral nutrition need, and anemia, but higher rates of fistulizing disease and lower GI hemorrhage.

Are oral fluid testing devices effective for the roadside detection of recent cannabis use? A systematic review.

Dobri, S C D · 2019

Nine oral fluid testing devices were evaluated, and none met the minimum 80% benchmark for sensitivity, specificity, and accuracy set by the ROSITA, ROSITA-2, and DRUID projects.

Cannabis as a cause of death: A review.

Drummer, Olaf H · 2019

At least 35 people presented with significant cardiovascular emergencies after recently smoking cannabis, and at least 13 deaths from cardiovascular mechanisms have been reported.

Marijuana use and driving in Washington State: Risk perceptions and behaviors before and after implementation of retail sales.

Eichelberger, Angela H · 2019

THC-positive daytime drivers increased from 8% before retail sales to 23% six months after.

Illicit drug use and prescription drug misuse among young adult medical cannabis patients and non-patient users in Los Angeles.

Fedorova, Ekaterina V · 2019

Self-reported medical cannabis use was associated with 50% lower odds of illicit drug use (AOR 0.5).

Strengths and limitations of two cannabis-impaired driving detection methods: a review of the literature.

Ginsburg, Brett C · 2019

Unlike alcohol, THC blood concentrations poorly correspond to amount consumed, crash risk, or degree of impairment.

Determining the Roles that Club Drugs, Marijuana, and Heavy Drinking Play in PrEP Medication Adherence Among Gay and Bisexual Men: Implications for Treatment and Research.

Grov, Christian · 2019

No event-level effect of marijuana use or heavy drinking on PrEP adherence was found.

Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.

Hasler, William L · 2019

CVS is characterized by severe episodic emesis with no randomized controlled trials to guide treatment.

Cannabis and Health Research: Rapid Progress Requires Innovative Research Designs.

Hutchison, Kent E · 2019

63% of the US population has access to medicinal cannabis markets offering increasingly diverse and potent products.

Perspectives on cannabis as a substitute for opioid analgesics.

Khan, Sara P · 2019

The review found evidence from preclinical, clinical, and epidemiological studies suggesting cannabis can complement or partially substitute for opioids in pain management, with some studies showing reduced opioid prescriptions in states with medical cannabis laws..

Guidelines for public health and safety metrics to evaluate the potential harms and benefits of cannabis regulation in Canada.

Lake, Stephanie · 2019

Twenty-eight indicators were identified under five themes: public safety, cannabis use trends, other substance use trends, cardiovascular/respiratory health, and mental health/cognition.

Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis.

Lake, Stephanie · 2019

After adjusting for demographics, substance use, and health factors, daily cannabis use was associated with significantly lower odds of daily illicit opioid use (adjusted OR 0.50, 95% CI 0.34-0.74, p < 0.001).

E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury - Utah, April-October 2019.

Lewis, Nathaniel · 2019

92% of interviewed patients reported using THC-containing products, 66% used nicotine products, and 60% used both.

Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients.

Lucas, Philippe · 2019

69.1% reported substituting cannabis for prescription drugs (35.3% of those for opioids), 44.5% for alcohol, 31.1% for tobacco, and 26.6% for illicit substances.

Cannabis Associated "High" Cardiovascular Morbidity and Mortality: Marijuana Smoke Like Tobacco Smoke? A Déjà Vu/Déjà Vécu Story?

Manolis, Theodora A · 2019

Despite different active ingredients (THC vs nicotine), cannabis and tobacco smoke contain largely identical combustion chemicals.

Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017.

Marx, Grace E · 2019

Of 44,942 total ER visits, 1% were flagged as potential marijuana cases; 188 of 422 reviewed records (45%) were confirmed acute adverse effects.

Cannabis and Male Fertility: A Systematic Review.

Payne, Kelly S · 2019

Cannabis was associated with reduced sperm count and concentration, abnormal morphology, reduced motility and viability, and inhibited capacitation and fertilizing capacity.

Cannabinoid Hyperemesis.

Pergolizzi, Joseph V · 2019

CHS presents as cyclical episodes of severe nausea and vomiting in long-term cannabis users, separated by asymptomatic periods.

Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis.

Pizzol, Damiano · 2019

Across 3,395 men (1,035 cannabis users, 2,360 controls), the overall ED prevalence was 69.1% in cannabis users versus 34.7% in controls.

Emergent Medical Illnesses Related to Cannabis Use.

Randall, Karen · 2019

Post-legalization ED presentations include cannabinoid hyperemesis, acute psychosis, cannabinoid catatonia syndrome, acute myo-pericarditis, pediatric ingestions, increases in fatal motor vehicle collisions, and hash-oil burn injuries.

Impacts of cannabinoid epigenetics on human development: reflections on Murphy et. al. 'cannabinoid exposure and altered DNA methylation in rat and human sperm' epigenetics 2018; 13: 1208-1221.

Reece, Albert Stuart · 2019

Building on the Murphy et al.

Cannabis use and acute coronary syndrome.

Richards, John R · 2019

Five Level I systematic reviews, 14 Level II studies (83,961 subjects), and 14 Level III studies (457,495 subjects) were identified.

Legalized Cannabis in Colorado Emergency Departments: A Cautionary Review of Negative Health and Safety Effects.

Roberts, Brad A · 2019

The most concerning effects were psychosis, suicide, and other substance abuse.

Use of Alcohol and Cannabis Among Adults Driving Children in Washington State.

Romano, Eduardo · 2019

Drivers with children were less likely to be alcohol positive (0.2% vs.

A Survey of Cannabis Acute Effects and Withdrawal Symptoms: Differential Responses Across User Types and Age.

Sexton, Michelle · 2019

Most common acute effects: improved sleep, calmness, desire to eat, creativity, dry mouth.

Trends and Related Factors of Cannabis-Associated Emergency Department Visits in the United States: 2006-2014.

Shen, Jay J · 2019

Cannabis-associated ED visits increased monotonically at 7% per year.

Cannabis and youth protection in Colorado's commercial adult-use market: A qualitative investigation.

Subritzky, Todd · 2019

Qualitative interviews with 32 key stakeholders and analysis of 13 government documents revealed five themes: advertising restrictions, education efforts, appropriation of funds for prevention, impact assessment challenges, and evolving messages in prevention campaigns.

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome.

Venkatesan, Thangam · 2019

Cannabis is commonly used in cyclic vomiting syndrome (CVS) for its antiemetic properties, yet chronic use has also been linked to cannabinoid hyperemesis syndrome (CHS).

Exploring the components of an efficacious computer brief intervention for reducing marijuana use among adults in the emergency department.

Waller, Rebecca · 2019

The "evoking-change" domain (concerns about use and benefits of change) was significantly associated with reduced marijuana use at 6 months (B=-2.91, p<0.01).

Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set.

Wolfe, Caitlin E · 2019

Of 23,947 ED presentations, 4.2% involved seizures.

Acute Cannabis Toxicity.

Wong, Kei U · 2019

Unintentional cannabis ingestions in children can cause significant toxicity including encephalopathy, coma, and respiratory depression.

Effects of the "Circle of Life" HIV-prevention program on marijuana use among American Indian middle school youths: a group randomized trial in a Northern Plains tribe.

Asdigian, Nancy L · 2018

Researchers evaluated a secondary benefit of the Circle of Life (COL) program, a culturally tailored HIV and STD prevention intervention delivered in all 13 middle schools on a rural Northern Plains reservation.

Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort.

Baron, Eric P · 2018

Researchers surveyed 2,032 medical cannabis patients and found that pain syndromes accounted for 42% of cannabis use, with chronic pain being the most common reason.

Cluster randomised controlled trial of an online intervention to prevent ecstasy and new psychoactive substance use among adolescents: final results and implications for implementation.

Champion, Katrina E · 2018

Researchers tested a web-based prevention program delivered through school health education classes to 1,126 Australian students across 11 schools.

Efficacy of a Web-Based Tailored Intervention to Reduce Cannabis Use Among Young People Attending Adult Education Centers in Quebec.

Côté, José · 2018

Researchers tested a theory-based, web-tailored intervention to reduce cannabis use among 588 young adults (ages 18-24) attending adult education centers in Quebec.

Validity of oral fluid test for Delta-9-tetrahydrocannabinol in drivers using the 2013 National Roadside Survey Data.

Jin, Huiyan · 2018

Researchers compared oral fluid and blood THC test results from 4,596 drivers stopped during the 2013 National Roadside Survey. Overall, 8.9% tested positive for THC in oral fluid and 9.4% in blood. Using blood testing as the reference standard, oral fluid testing showed 79.4% sensitivity (correctly identifying positive cases) and 98.3% specificity (correctly identifying negative cases). However, oral fluid THC concentration was a poor predictor of actual blood THC levels.

Cannabis use predicts risks of heart failure and cerebrovascular accidents: results from the National Inpatient Sample.

Kalla, Aditi · 2018

Researchers identified cannabis users aged 18-55 in the National Inpatient Sample 2009-2010 database and compared their cardiovascular outcomes to the general population. Prevalence of heart failure, stroke, coronary artery disease, sudden cardiac death, and hypertension were all significantly higher in cannabis users. After multivariate regression adjusting for age, sex, hypertension, diabetes, hyperlipidemia, coronary artery disease, tobacco use, and alcohol use, cannabis use remained an independent predictor of heart failure (OR 1.1, 95% CI 1.03-1.18) and stroke (OR 1.24, 95% CI 1.14-1.34). The stroke association was notably stronger than the heart failure association..

Cannabinoid Hyperemesis Syndrome: Public Health Implications and a Novel Model Treatment Guideline.

Lapoint, Jeff · 2018

The San Diego Emergency Medicine Oversight Commission, county health services, and Kaiser Permanente toxicology created an expert consensus guideline for CHS treatment. Key recommendations: - Treatment should focus on symptom relief and patient education about cannabis cessation. - Topical capsaicin (the active compound in chili peppers) is recommended as a first-line treatment.

Growing practices and the use of potentially harmful chemical additives among a sample of small-scale cannabis growers in three countries.

Lenton, Simon · 2018

Researchers surveyed 1,722 current and recent small-scale recreational cannabis growers across three countries about their growing practices. Overall, 44% reported using any chemical fertilizers, supplements, or insecticides. Logistic regression found that hydroponic growing was the only significant predictor of chemical use.

Practical considerations in medical cannabis administration and dosing.

MacCallum, Caroline A · 2018

The authors compiled practical clinical guidance for medical cannabis dosing and administration. Key recommendations: - Total daily THC should generally be limited to 30 mg/day or less to avoid psychoactive effects and tolerance development. - THC should preferably be combined with CBD, which can attenuate THC-associated anxiety and tachycardia. - CBD is less potent than THC and may require much higher doses for its anti-inflammatory and analgesic benefits. - Dose initiation should start at modest levels with slow titration over up to two weeks. - Administration methods covered include smoking, vaporization, and oral ingestion, each with different onset times and bioavailability profiles. The review addressed cannabis-drug interactions, patient monitoring standards, and special populations including epilepsy, cancer, chronic pain, elderly patients, Parkinson's disease, pediatrics, concurrent opioid use, and driving..

Heavy Cannabis Use Associated With Reduction in Activated and Inflammatory Immune Cell Frequencies in Antiretroviral Therapy-Treated Human Immunodeficiency Virus-Infected Individuals.

Manuzak, Jennifer A · 2018

Researchers measured immune cell activation in 198 HIV-positive individuals on antiretroviral therapy, categorized by cannabis use level based on plasma THC metabolite concentration. Heavy cannabis users had significantly decreased frequencies of activated (HLA-DR+CD38+) CD4+ and CD8+ T cells compared to non-users. Heavy users also had decreased frequencies of intermediate and nonclassical monocyte subsets (inflammatory monocyte types). Additionally, heavy cannabis users had reduced frequencies of antigen-presenting cells producing interleukin-23 and TNF-α, two pro-inflammatory cytokines. The authors noted that while clinical implications are unclear, these findings suggest cannabis use is associated with a "potentially beneficial reduction in systemic inflammation and immune activation" in the context of treated HIV..

Marijuana Use in Pregnancy and While Breastfeeding.

Metz, Torri D · 2018

Researchers reviewed the literature on marijuana use during pregnancy and breastfeeding, published in a major obstetrics journal. Key findings: - Marijuana crosses the placenta and is present in breast milk, directly exposing the fetus and nursing infant. - The endocannabinoid system plays important roles in implantation, placentation, and fetal neurologic development, making disruption biologically plausible. - Two recent systematic reviews and meta-analyses found associations between marijuana use and adverse perinatal outcomes, especially with heavy use. - Three longitudinal cohort studies demonstrated possible effects of prenatal exposure on long-term neurobehavioral outcomes in children. - Marijuana use may be associated with growth restriction, stillbirth, spontaneous preterm birth, and NICU admission. - Many women cited medical reasons for prenatal use: nausea/vomiting, anxiety, and chronic pain. Limitations acknowledged: most studies are retrospective, rely on self-report (which underestimates use), and many fail to adequately control for tobacco and sociodemographic confounders. Despite these limitations, the authors recommended women refrain from marijuana during pregnancy and lactation..

Day-Level Associations Between Substance Use and HIV Risk Behavior Among a Diverse Sample of Transgender Women.

Millar, Brett M · 2018

Researchers collected 60-day timeline follow-back data from 214 transgender women in New York City to examine day-level links between substance use and sexual risk behavior. All three substance types studied (heavy drinking, marijuana, stimulants) were associated with greater odds of any sexual activity on days when used. Critically, only marijuana use was associated with increased odds of HIV transmission risk behavior (TRB) on days when sex occurred.

Universal cannabis outcomes from the Climate and Preventure (CAP) study: a cluster randomised controlled trial.

Newton, Nicola C · 2018

Researchers randomized 26 Australian high schools (2,190 students, mean age 13.3) to four conditions: universal prevention (Climate), selective prevention for high-risk students (Preventure), combined (CAP), or health education as usual. Both Climate and CAP groups showed significantly greater increases in cannabis-related knowledge compared to controls (p < 0.001), with higher knowledge maintained at 6, 12, and 24 months. There was no significant difference between Climate and CAP groups, suggesting the combined approach did not add knowledge benefit beyond the universal program alone. No significant differences were detected between intervention and control groups on cannabis use or cannabis-related harms.

Prevalence and Sociodemographic Correlates of Adolescent Use and Polyuse of Combustible, Vaporized, and Edible Cannabis Products.

Peters, Erica N · 2018

Researchers surveyed 3,177 tenth-grade students (mean age 16.1, 54% girls) from 10 Los Angeles high schools. Ever-use prevalence: combustible (smoking) 31.3%, edible 21.3%, vaporized 10.5%.

Cannabis use is associated with lower rates of initiation of injection drug use among street-involved youth: A longitudinal analysis.

Reddon, Hudson · 2018

In a multivariable analysis, daily or more frequent cannabis use was associated with slower rates of injection drug initiation (adjusted hazard ratio 0.66, 95% CI 0.45-0.98).

Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department.

Richards, John R · 2018

CHS may result from the endocannabinoid system being overwhelmed by chronic cannabis use, with acute episodes triggered by stress or fasting.

Cannabinoid hyperemesis syndrome: Review of the literature and of cases reported to the French addictovigilance network.

Schreck, Benoît · 2018

CHS mainly affects young male subjects who have smoked cannabis daily for several years.

High-intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis.

Socías, Maria Eugenia · 2018

Daily cannabis use was positively associated with retention in OAT (adjusted OR 1.21, 95% CI 1.04-1.41).

Cannabinoids: emerging evidence in use and abuse.

Williams, Molly V · 2018

Emergency departments are seeing increasing cannabinoid-related presentations.

Marijuana and Tobacco Coexposure in Hospitalized Children.

Wilson, Karen M · 2018

46% of children had detectable COOH-THC (marijuana metabolite) and 11% had detectable THC itself.

Surgical considerations of marijuana use in elective procedures

Huson, Henry B · 2018

Chronic cannabis users may require substantially more sedation for procedures (up to 220% more propofol in one study).

Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment.

Blumentrath, Christian G · 2017

Cannabinoid hyperemesis syndrome (CHS) and cyclic vomiting syndrome (CVS) share nearly identical presentations: recurrent episodes of severe nausea, vomiting, and abdominal pain.

Marijuana and other substance use among male and female underage drinkers who drive after drinking and ride with those who drive after drinking.

Buckley, Lisa · 2017

In a sample of 2,150 underage drinkers (ages 16-20) from an emergency department, driving after drinking (DD) was reported by 22% of females and 28% of males.

Trends of Cannabis Use Disorder in the Inpatient: 2002 to 2011.

Charilaou, Paris · 2017

Among nearly 2.8 million hospital admissions with documented cannabis abuse/dependence (0.91% of all admissions), prevalence increased from 0.52% to 1.34% over the decade.

Lung Disease Associated With Marijuana Use.

Chatkin, José Miguel · 2017

The review established that marijuana smoke and tobacco smoke share many of the same combustion byproducts, including carcinogens and respiratory irritants.

Alcohol or Drug Use and Trauma Recidivism.

Cordovilla-Guardia, Sergio · 2017

Of 1,156 trauma patients (ages 16-70) hospitalized between 2011 and 2015, at least one substance was detected in 45.1%.

School Protective Factors and Substance Use Among Lesbian, Gay, and Bisexual Adolescents in California Public Schools.

De Pedro, Kris Tunac · 2017

Analysis of California Healthy Kids Survey data (2013-2015) revealed that school protective factors were significantly associated with lower substance use among LGB youth.

Validation of a Syndromic Case Definition for Detecting Emergency Department Visits Potentially Related to Marijuana.

DeYoung, Kathryn · 2017

Researchers developed and validated a case definition for identifying marijuana-related ER visits using structured and free-text data from 15 Denver hospitals.

The role of illicit drug use in sudden death in the young.

Fischbach, Peter · 2017

The review assessed the cardiac risks of major illicit drugs in young people.

Marijuana Use in Pregnancy: Concerns in an Evolving Era.

Foeller, Megan E · 2017

Marijuana is the most commonly used illicit drug during pregnancy, and its use is increasing in the US.

Cannabis: An Overview of its Adverse Acute and Chronic Effects and its Implications.

Ford, Talitha C · 2017

The review surveyed evidence across multiple domains of cannabis harm.

Health effects of exposure to second- and third-hand marijuana smoke: a systematic review.

Holitzki, Hannah · 2017

This systematic review examined 15 studies on the health effects of secondhand marijuana smoke exposure, finding three consistent outcomes. First, exposure to secondhand marijuana smoke produces detectable levels of cannabinoid metabolites (THC breakdown products) in the blood and urine of non-smokers.

Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review.

Richards, John R · 2017

The systematic review analyzed 63 eligible articles covering 205 CHS patients.

Alternate policing strategies: Cost-effectiveness of cautioning for cannabis offences.

Shanahan, Marian · 2017

Researchers compared two police responses to minor cannabis offenses in Australia: formal caution (with referral to education/treatment) versus traditional arrest and charge. Among 544 matched offenders (195 arrested, 355 cautioned), there was no statistically significant difference in self-reported cannabis use days before and after the police intervention between the two groups.

Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors.

Lucas, Philippe · 2016

This large survey of Canadian medical cannabis patients revealed remarkably high rates of substance substitution.

Characteristics of Cannabis-Only and Other Drug Users Who Visit the Emergency Department.

Woodruff, Susan I · 2016

Researchers compared three groups among 686 adult emergency department patients who reported drug use: daily cannabis-only users, non-daily cannabis-only users, and users of other drugs. The three groups did not differ on most demographic factors or medical problem severity, but they differed significantly on substance-related outcomes.

Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011.

Zhu, He · 2016

Between 2004 and 2011, cannabis-only ER visit rates increased from 51 to 73 per 100,000 people aged 12 and older, while cannabis-polydrug visit rates rose from 63 to 100 per 100,000.

Examination of the role of the combination of alcohol and cannabis in South Australian road crashes.

Baldock, M R J · 2015

Researchers analyzed hospital and forensic data from 1,074 crash-involved drivers and motorcyclists admitted to hospitals in South Australia over three years.

Butane Hash Oil Burns Associated with Marijuana Liberalization in Colorado.

Bell, Cameron · 2015

Researchers documented all hydrocarbon burns related to butane hash oil (BHO) extraction admitted to a Colorado burn center from 2008 through 2014.

Nonsmoker Exposure to Secondhand Cannabis Smoke. III. Oral Fluid and Blood Drug Concentrations and Corresponding Subjective Effects.

Cone, Edward J · 2015

Six non-smokers sat alternately with six cannabis smokers in a sealed chamber for one hour across three sessions.

Non-smoker exposure to secondhand cannabis smoke. I. Urine screening and confirmation results.

Cone, Edward J · 2015

Six non-smokers were exposed to secondhand cannabis smoke in a sealed chamber with six smokers for one hour across three sessions.

The combined effects of alcohol and cannabis on driving: Impact on crash risk.

Dubois, Sacha · 2015

Researchers examined drivers aged 20+ involved in fatal crashes in the United States from 1991 to 2008 who had been tested for both alcohol and cannabis.

Non-smoker exposure to secondhand cannabis smoke II: Effect of room ventilation on the physiological, subjective, and behavioral/cognitive effects.

Herrmann, Evan S · 2015

Non-cannabis-using individuals were exposed to secondhand smoke from six people smoking 11.3% THC cannabis in a sealed chamber for one hour under two conditions: unventilated and ventilated (11 air exchanges per hour). Unventilated exposure produced detectable THC in blood and urine, minor heart rate increases, mild-to-moderate self-reported sedation, and impaired performance on a cognitive task (digit symbol substitution).

The effects of marijuana exposure on expiratory airflow. A study of adults who participated in the U.S. National Health and Nutrition Examination Study.

Kempker, Jordan A · 2015

Researchers analyzed lung function data from over 100,000 U.S.

Cannabinoid hyperemesis syndrome: Marijuana is both antiemetic and proemetic.

Lu, Marvin Louis Roy Y · 2015

This clinical review described cannabinoid hyperemesis syndrome (CHS), a paradoxical condition where chronic marijuana use causes recurrent severe nausea and vomiting despite cannabis being known as an antiemetic. The syndrome typically presents with cyclic episodes of vomiting, often accompanied by compulsive hot bathing (which temporarily relieves symptoms).

Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population.

Macleod, John · 2015

Researchers recruited 500 people from a Scottish general practice: some smoked only tobacco, others smoked both tobacco and cannabis (predominantly resin mixed with tobacco).

Can cannabis use be prevented by targeting personality risk in schools? Twenty-four-month outcome of the adventure trial on cannabis use: a cluster-randomized controlled trial.

Mahu, Ioan T · 2015

Researchers randomized 21 London secondary schools to receive either personality-targeted interventions or standard programming.

Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention.

Miovský, Michal · 2015

Researchers used a randomized controlled prevention trial with 1,874 sixth-graders (average age 11.8) to predict how a universal prevention program would affect individual children based on their specific risk profiles. Using eight risk and protective factors, they calculated personalized probabilities of cannabis use for each child with and without the intervention.

An economic analysis of different cannabis decriminalization scenarios.

Ogrodnik, Marysia · 2015

This economic review compared cannabis policy models from around the world, from full prohibition to consumption tolerance (Netherlands) to legalized markets (Uruguay, U.S.

Global patterns of domestic cannabis cultivation: sample characteristics and patterns of growing across eleven countries.

Potter, Gary R · 2015

The Global Cannabis Cultivation Research Consortium surveyed 6,530 predominantly small-scale cannabis growers from 11 countries about their demographics, methods, motivations, and criminal justice contacts. The findings were remarkably consistent across countries: most growers came from "normal" rather than "deviant" backgrounds.

A review of co-morbid tobacco and cannabis use disorders: possible mechanisms to explain high rates of co-use.

Rabin, Rachel Allison · 2015

This review examined why tobacco and cannabis are so frequently used together and why co-use complicates treatment of both substances. The evidence showed bidirectional effects: tobacco use increases the likelihood of becoming cannabis dependent, and cannabis use promotes transition to heavier tobacco use.

Cannabinoids for medical use: A systematic review and meta-analysis

Whiting, Penny F. · 2015

Across 79 RCTs, cannabinoids were linked to better symptom outcomes than placebo for several indications, but effects were often small and not consistently statistically significant across trials.

Short-term mediating factors of a school-based intervention to prevent youth substance use in Europe.

Giannotta, Fabrizia · 2014

In a randomized trial across 143 schools in seven European countries (7,079 students), the Unplugged social influence-based prevention program was compared to usual health education.

Is Project Towards No Drug Abuse (Project TND) an evidence-based drug and violence prevention program? A review and reappraisal of the evaluation studies.

Gorman, Dennis M · 2014

This critical review examined all published evaluations of Project Towards No Drug Abuse (Project TND), a school-based prevention program.

Detection of new psychoactive substance use among emergency room patients: results from the Swedish STRIDA project.

Helander, Anders · 2014

The STRIDA project monitored new psychoactive substance (NPS) use among patients presenting to Swedish emergency departments and intensive care units.

A universal harm-minimisation approach to preventing psychostimulant and cannabis use in adolescents: a cluster randomised controlled trial.

Vogl, Laura Elise · 2014

Among 1,734 Year 10 students (mean age 15.4) across 21 Australian schools, the computer-based Climate Schools program increased knowledge of cannabis and psychostimulants and decreased pro-drug attitudes compared to usual drug education. The program subdued ecstasy uptake and plateaued use frequency in the short term, though no effects on meth/amphetamine use were found.

The effect of tobacco and marijuana use on dental health status in Nevada adolescents: a trend analysis.

Ditmyer, Marcia · 2013

Researchers screened 66,941 adolescents (ages 13-18) across Nevada middle and high schools from 2002 to 2010.

Marijuana poisoning.

Fitzgerald, Kevin T · 2013

The review documented the clinical picture of marijuana poisoning in companion animals, primarily dogs.

Brief emergency department interventions for youth who use alcohol and other drugs: a systematic review.

Newton, Amanda S · 2013

Nine randomized controlled trials of emergency department-based brief interventions (BIs) for youth ages 21 and under were reviewed.

Analysis of cannabis seizures in NSW, Australia: cannabis potency and cannabinoid profile.

Swift, Wendy · 2013

Researchers analyzed 206 cannabis samples confiscated from recreational users under the New South Wales Cannabis Cautioning scheme, along with 26 samples from known indoor or outdoor cultivation sites.

Cannabis as an adjunct to or substitute for opiates in the treatment of chronic pain.

Lucas, Philippe · 2012

This review compiled evidence from preclinical and clinical sources on using cannabis as an adjunct to or substitute for opiates in chronic pain.

Enhancement drugs: are there limits to what we should enhance and why?

Hesse, Morten · 2010

This commentary made two specific harm-reduction proposals: For alcohol: adding dissolved oxygen could reduce accident risk and liver damage. For cannabis: strong evidence indicated that reducing THC content and increasing CBD content could reduce the risk of psychosis and addiction associated with cannabis use. The author argued that public health interventions should focus on reducing concrete harms rather than making moral judgments about which human experiences should or should not be enhanced through substance use. The central proposition was that responsible regulation should not be limited to preventing or reducing use, but should include strategies to reduce the burden of illness associated with substance use..

Reductions in heroin use are not associated with increases in other drug use: 2-year findings from the Australian Treatment Outcome Study.

Darke, Shane · 2006

Researchers followed 615 heroin users recruited for the Australian Treatment Outcome Study at 3, 12, and 24 months.

Drug testing in oral fluid.

Drummer, Olaf H · 2006

This review covered a decade of developments in oral fluid drug testing.

Results of hair analyses for drugs of abuse and comparison with self-reports and urine tests.

Musshoff, F · 2006

Researchers compared self-reported drug use with urine immunoassay and hair analysis by GC-MS in a group of drug abusers.

Cannabinoids and cancer: causation, remediation, and palliation.

Hall, Wayne · 2005

This review addressed three distinct relationships between cannabinoids and cancer. First, regarding cancer causation: case reports linked cannabis smoking to upper respiratory tract cancers in young adults, but epidemiological evidence from cohort and case-control studies was inconsistent. Second, regarding anti-tumor effects: some lab studies showed THC and synthetic cannabinoids had antineoplastic effects, while others showed THC impaired immune responses to cancer.

Drugs and driving: the Finnish perspective.

Lillsunde, P · 2005

This review examined drug-impaired driving from a Finnish and European perspective.

Passive cannabis smoke exposure and oral fluid testing. II. Two studies of extreme cannabis smoke exposure in a motor vehicle.

Niedbala, R Sam · 2005

Researchers conducted two studies where four non-smoking subjects sat alongside four active cannabis smokers in an unventilated eight-passenger van.

Human studies of cannabinoids and medicinal cannabis.

Robson, P · 2005

This review traced the arc of medicinal cannabis from its prominence in 19th century Western medicine through its early 20th century prohibition and 1960s recreational explosion, to the current state of clinical research. The author identified major methodological challenges that had kept clinical evidence weak: studies tended to be small, imperfectly controlled, and often used synthetic cannabinoid analogs or smoked herbal material with uncertain composition and irregular bioavailability. New research opportunities were emerging from three developments: the discovery of the endocannabinoid system, expanding knowledge of cannabinoid pharmacology, and a more sympathetic political environment in several countries.

Smoked marijuana as a cause of lung injury.

Tashkin, D P · 2005

This review by a leading pulmonologist examined the lung effects of marijuana smoking.

Delta9-tetrahydrocannabivarin as a marker for the ingestion of marijuana versus Marinol: results of a clinical study.

ElSohly, M A · 2001

Because synthetic THC (Marinol) and natural marijuana produce identical urinary metabolites, drug tests cannot tell them apart.

Cannabidiol reduces oxycodone self-administration while preserving its analgesic efficacy in a rat model of neuropathic pain.

Bruijnzeel, Adriaan W · 2026

This study addresses one of the most pressing questions in pain medicine: can we reduce opioid misuse without taking away pain relief? Rats were trained to self-administer oxycodone (pressing a lever to receive intravenous doses), then given chronic neuropathic pain via sciatic nerve injury.

Health impacts of cannabis: focus on smoking vs. vaping effects on the respiratory and cardiovascular systems.

Chaiton, Michael · 2026

As cannabis legalization shifts consumption patterns toward vaping, this review compares what we know about the health effects of the two main inhalation methods. The good news for vaping: it reduces exposure to the combustion byproducts (tar, carbon monoxide, polyaromatic hydrocarbons) that make smoking harmful.

State Initiatives to Promote Cannabis Industry Entrepreneurship Among Disproportionately Impacted Communities: A Multi-State Analysis.

Chakraborty, Rishika · 2026

This multi-state analysis examined social equity entrepreneurship initiatives across all 17 states with legal non-medical cannabis retail as of May 2025.

Semi-synthetic cannabinoids: Recent developments, analytical challenges and strategic responses.

Christie, Rachel · 2026

Since hexahydrocannabinol (HHC) first appeared in Europe in late 2022, the semi-synthetic cannabinoid market has expanded rapidly.

Exploring THC labelling preferences to communicate the strength of cannabis products: Insights from U.S. consumers.

Dawson, Danielle · 2026

Most respondents considered it important for cannabis products to include THC information.

Dissociative-like Neurotoxicity Following Analytically Confirmed Exposure To Hexahydrocannabinol (HHC).

Greene, Shaun L · 2026

In this individual case, a 32-year-old man developed a dissociative-like neurologic syndrome plus gastrointestinal symptoms after ingesting a single gummy sold as a THC product.

The Exploration of Cannabis Beverage Substitution for Alcohol: A Novel Harm Reduction Strategy.

Kruger, Jessica S · 2026

Cannabis beverage users reported fewer weekly alcoholic drinks after starting cannabis beverages (3.35 vs.

Cannabis smoke extract disrupts trophoblast differentiation and causes mitochondrial dysfunction beyond the effects of Δ9-THC alone.

Monaco, Cristina · 2026

Cannabis smoke extract (CaSE) reduced markers of placental cell maturation (hCG protein and syncytin-1 gene expression) and caused dose-dependent mitochondrial dysfunction.

A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.

Pleasant, Traben · 2026

Through interviews with 33 veterans receiving care in a VA substance use disorder treatment program, researchers documented how veterans with chronic pain viewed and used cannabis alongside their addiction treatment. Most participants had a primary diagnosis of alcohol use disorder (70%), followed by opioid use disorder (18%) and stimulant use disorder (12%).

Measuring cannabis use and cannabis-related consequences among college students who engage in simultaneous alcohol and cannabis use: Associations by type of cannabis product and mode of use on weekend days with cannabis.

Shipley, Jennifer L · 2026

Participants reported more hits on days using joints, vapes, blunts, or other modes compared to bong use.

Fast and reliable in vitro activity-based detection of synthetic cannabinoid receptor agonists in e-liquids.

Timmerman, Axelle · 2026

Researchers applied a cell-based activity screening method (CB1/β-arrestin2 recruitment assay using the NanoBiT principle) to detect synthetic cannabinoid receptor agonists (SCRAs) in e-liquids — the first time this approach was used on a real patient case. When applied to an e-liquid from an intoxicated patient, the assay demonstrated strong cannabinoid activity, confirming the presence of SCRAs.

In Their Own Words: A Qualitative Exploration of Veterans' Perspectives and Experiences of Medical Cannabis Use.

Ward, Rachel · 2026

Veterans used cannabis for a variety of health conditions and perceived few or no harms, or felt benefits outweighed risks.

Cannabis vaping elicits transcriptomic and metabolomic changes involved in inflammatory, oxidative stress, and cancer pathways in human bronchial epithelial cells.

Arlen, Maddison T · 2025

The shift from smoking to vaping cannabis is driven largely by the belief that vaping is safer.

Cannabis Use in Opioid Maintenance Therapy: Prevalence, Clinical Correlates and Reasons for Use.

Backmund, Markus · 2025

Cannabis use was reported by 41% of opioid maintenance patients.

Does cannabis use substitute for opioids? A preliminary exploratory survey in opioid maintenance patients.

Bekier, Nina Kim · 2025

Sixty percent of opioid maintenance patients reported cannabis use.

A pilot randomized controlled trial of a digital cannabis harm reduction intervention for young adults with first-episode psychosis who use cannabis.

Coronado-Montoya, Stephanie · 2025

Trial retention was 82.2% and CHAMPS completion rate was 58.8%, meeting pre-specified thresholds for feasibility and acceptability.

A Mobile App (Joint Effort) to Support Cannabis Use Self-Management and Reinforce the Use of Protective Behavioral Strategies: Development Process and Usability Testing.

Côté, José · 2025

The app scored 4.43 out of 5.0 on the Mobile Application Rating Scale, with particularly high marks for functionality (4.60) and aesthetics (4.53)..

An Outbreak of Synthetic Cannabinoid-Adulterated Tianeptine Products in New Jersey - Case Series.

Counts, Christopher J · 2025

Products marketed as containing tianeptine were found to contain the synthetic cannabinoids MDMB-4en-PINACA and ADB-4en-PINACA.

Detection and quantification of synthetic cannabinoids in seven illicitly sourced disposable vapes submitted by an individual presenting to a UK drug and alcohol service.

Craft, Sam · 2025

All seven samples contained 5F-MDMB-PICA at a median concentration of 0.85 mg/mL (range 0.59-1.63 mg/mL).

"It's legal, now what?" development, implementation, and evaluation of interdisciplinary cannabis education for healthcare trainees.

Cronin, Sean P · 2025

345 trainees in pharmacy, nursing, public health, and medicine completed the program.

Identification of Three Novel Tetrahydrocannabinol Analogs in the European Market.

Dadiotis, Evangelos · 2025

Products marketed under invented cannabinoid names contained novel THC analogs that have never been found in cannabis plants and lack any toxicological data.

Intranasal naloxone to treat suspected synthetic cannabinoid overdose: A case report and literature review.

Dickinson, Jaden · 2025

A 43-year-old man with schizoaffective disorder presented with altered mental status and respiratory depression after suspected K2 use.

Modes of cannabis use, frequency of use, and cannabis use problems: A latent profile analysis of modes of cannabis use.

Dyar, Christina · 2025

Four groups emerged: smoking (reference), vaping concentrates, edible use, and multiple modes.

Event-Level Differences in Quantity, Frequency, and Consequences of Cannabis Use by Modes of Use Among Sexual Minority Women and Gender Diverse Individuals.

Dyar, Christina · 2025

People who used edibles infrequently experienced more negative consequences from edibles compared to smoking, while frequent edible users did not show this difference..

Cannabinoid Hyperemesis Syndrome: A Rare Cause of Severe Abdominal Pain and Hyperlactataemia.

Elbaghdady, Ahmad · 2025

The patient's lactate reached 6.1 mmol/L, a level indicating significant physiological stress, caused by severe dehydration and pain from intractable vomiting rather than from another underlying emergency..

Infant Death due to Cannabis Ingestion.

Favretto, Donata · 2025

The child showed altered walking, balance, and consciousness after ingesting hashish, followed by respiratory failure.

Medical Cannabis Use Adjunct to Standard of Care in a Residential Substance Use Recovery Program: A Pilot Study.

Fehr, Florriann C · 2025

Clients reported cannabis substitution reduced cravings for problematic substances and helped with pain and comorbid symptoms.

Cannabis User Perceptions: General and Oral Health Benefits and Harms of Vaping Versus Smoking.

Fisher, Jennifer M · 2025

Among 302 current cannabis users, the most commonly reported health benefit of vaping was better pain management (72.5%).

Cannabinoid exposure in infants and children in the pediatric emergency department-the child protection perspective.

Fridler, Dvora · 2025

Over 10 years, 29 children 0-48 months tested positive for cannabis.

Conceptualizing 'cannabis harm reduction': lessons learned from cannabis compassion clubs and medical dispensaries in British Columbia (Canada).

Gagnon, Marilou · 2025

Through interviews and document analysis, researchers identified structural (addressing systemic barriers through access, safety, quality) and operational (low-threshold, compassionate services with support) dimensions of cannabis harm reduction that worked together..

Mobile intervention to address cannabis use disorder among black adults: A proof-of-concept randomized controlled trial.

Garey, Lorra · 2025

Black adults who use cannabis face documented health disparities: more frequent use and higher rates of cannabis use disorder compared to White adults, yet they are underrepresented in treatment research and face greater barriers to accessing care.

UK Medical Cannabis Registry: A Clinical Analysis of Patients with Substance Use Disorder.

Ghosh, Aishwarya · 2025

Patients showed improvements in GAD-7 anxiety scores, sleep quality, and EQ-5D-5L quality of life at 1, 3, and 6 months.

Ethnic variations in sedentary behavior and marijuana use among U.S. adults: A cross-sectional analysis.

Li, Yunzhe · 2025

Among 7,122 US adults, longer sitting time was associated with lower odds of marijuana use.

Commercial Cannabis Product Testing: Fidelity to Labels and Regulations.

Limbacher, Sarah · 2025

Overall, label values were significantly higher than tested values for flower and edible products (p<0.001), but not for concentrates (p=0.85).

Mode Matters: Investigating the Associations Between Mode of Cannabis Use and Self-Reported Physical and Psychological Effects.

MacDonald-Spracklin, Rachael · 2025

Bong use predicted significantly more physical and psychological health effects than other methods.

Recommendations From Arizona Budtenders to Mystery Callers Regarding Morning Sickness.

Madson, Michael J · 2025

71.2% of budtenders recommended cannabis products for morning sickness, particularly CBD products and edibles.

Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study.

Martínez, Cristina · 2025

Five themes emerged from clinician focus groups: individual characteristics, clinician characteristics, intervention models, organizational healthcare models, and health policies.

"Well, if they exist, I ignore them": A focus group study of recall and reactions to cannabis health warnings by cannabis consumers in the United States.

Massey, Zachary B · 2025

Cannabis consumers reported being unaware of or choosing to ignore health warnings on products they used.

Parent and caregiver perceptions of cannabidiol products may put children at risk for unintentional exposure.

McNally, Michael · 2025

While most parents and caregivers had heard of CBD, opinions split on whether CBD products pose safety risks to children.

Mental health clinicians' perceptions on patient motivations and intervention engagement for prenatal cannabis use: A mixed methods study.

Mian, Maha N · 2025

Among 26 perinatal mental health clinicians, nausea/morning sickness was identified as the most common motive for prenatal cannabis use.

Portrayal of Delta-8 Tetrahydrocannabinol (THC) on YouTube.

Olsson, Sofia E · 2025

Four themes emerged: reasons to use (legal status, accessibility, psychoactive effects described as milder and more euphoric), how to use, effects of using, and safety/harm reduction.

Emerging Hemp-Derived Semi-Synthetic Cannabinoids, Absent Regulations: Patterns of Use and Adverse Effects Among a Sample of U.S. Cannabis Consumers.

Pabon, Elisa · 2025

Delta-8 THC (21.8%), THCP (24.4%), and Delta-10 THC (14.0%) were the most commonly used semi-synthetic cannabinoids.

Work-Related Asthma in the Cannabis Industry: Findings From California, Massachusetts, Michigan, and Washington.

Pacheco, Michelle · 2025

Of 30 work-related asthma cases in the cannabis industry, 52% were new-onset asthma and 48% were work-aggravated asthma.

Exacerbated cardiac dysfunction from combined alcohol binge and synthetic cannabinoid use.

Paloczi, Janos · 2025

Both alcohol and the synthetic cannabinoid CP55,940 independently caused dose-dependent declines in heart contractile function in mice.

Cannabinoids and alcohol co-exposure modulate pathogen-induced pulmonary immune responses.

Parker, De'Jana · 2025

Adolescent cannabinoid exposure primed mouse lungs for more severe inflammation when later infected with Klebsiella pneumoniae.

Advertising Among Cannabidiol (CBD) Retailers in North Carolina: A Pilot Study.

Parker, Renee · 2025

All 13 CBD retailers displayed advertisements containing either misleading product descriptors or unapproved health claims.

Daily Cannabis Use: Do Impulsivity and Sensation Seeking Predict Negative Cannabis Related Consequences?

Parnes, Jamie E · 2025

Among daily legal cannabis users, risk-seeking personality was significantly positively associated with negative cannabis-related consequences.

Clinicians' attitudes and knowledge of medicinal cannabis in opioid dependence treatment clinics in New South Wales, Australia.

Parvaresh, Laila · 2025

88.5% of clinicians lacked experience providing medicinal cannabis.

Clinicians' Perspectives on Cannabis Use and Cannabis Treatment in Clients Undertaking Opioid Dependence Treatment.

Parvaresh, Laila · 2025

Clinicians estimated 56.1% of OTP clients had used cannabis in the past month and 44.9% had cannabis dependence, but only 15.3% identified their cannabis use as problematic and 10.7% sought treatment.

A retrospective medical record audit of the management of cannabis-related emergency department presentations, hospital admissions and hyperemesis of pregnant women who self-reported non-medicinal cannabis use to a substance use in parenting and pregnancy service.

Qian, Siyu · 2025

Among 75 pregnant SUPPS patients with cannabis as primary drug of concern, their 232 ED presentations and 183 hospital admissions revealed significant gaps: cannabis use history was documented in only 34% of ED visits and 53% of admissions.

Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States.

Ranney, Leah M · 2025

In six focus groups with 36 U.S.

A Thematic Text Analysis of Cannabis Edibles Brand Names.

Reboussin, Beth A · 2025

Among 1,344 cannabis edible products from 250 brands, five brand name themes emerged: cannabis culture (42%), product characteristics (30%), medicine/health (23%), environment/nature (20%), and identity/culture (14%).

Long-Lasting Cognitive and Physical Impairment After Recreational Use of the Semisynthetic Cannabinoid Hexahydrocannabinonyl (HHC-C9): A Case Report.

Reiter, Nanna · 2025

After eating two cannabis cookies labeled as containing 40 mg "CC9" and biting a gummy with unknown contents, a man in his early forties required emergency admission for deficits in alertness and responsiveness.

Efficacy of a neuroscience informed psychoeducation intervention on cognitive, emotional, and substance use outcomes in college students: a pilot study.

Rezapour, Tara · 2025

After four 20-minute NIPA sessions, 68 college students showed significant reductions in executive function deficits, stress, and anxiety.

A user-informed perspective of the toxicological data gap in India's cannabis landscape.

Riyaz, Muzafar · 2025

The author argues that clinical cannabis research using purified compounds fails to capture the realities of illicit markets where products like Ganja and Charas have unpredictable potency, pesticide contamination, and adulteration.

Cannabis Use Moderates Methamphetamine- and HIV-Related Inflammation: Evidence from Human Plasma Markers.

Rogers, Jeffrey M · 2025

Among 234 participants (86 with HIV, 148 without), past-month cannabis use was independently associated with lower CXCL10/IP-10 levels overall.

Recognizing Cannabis Hyperemesis Syndrome in Pediatric Patients: Insights From a Case Report.

Rucinski, Pawel · 2025

A 16.5-year-old male presented with a 2-year history of vomiting episodes lasting up to 10 days, with abdominal pain and weight loss.

Associations Between Food Restriction, Alcohol and Marijuana Use and Co-Use, and Consequences Among College Students.

Shute, Ireland M · 2025

Among past 30-day marijuana users, hours spent high and food restriction on use days independently predicted greater marijuana-related consequences.

Development of a motivational enhancement therapy cannabis-reduction intervention for young adults experiencing psychosis: A feasibility pilot study.

Walker, Denise D · 2025

The Cannabis Check-Up for Psychosis (CCU-P) — a two-session motivational enhancement therapy intervention — demonstrated 92% completion rate (11 of 12 completed both sessions), high satisfaction ratings, and all participants said they would recommend it to others in Coordinated Specialty Care..

A proof-of-concept study examining a health communication intervention to reduce cannabis misuse among college students.

Willoughby, Jessica Fitts · 2025

The intervention, voiced by a cannabis marketing professional, effectively shifted student attitudes and intentions around cannabis misuse in a pre/post-test design with 64 participants..

Impact of Marijuana Use on Lung Health.

Bando, Joanne M · 2024

This is one of the central paradoxes in cannabis research: smoked marijuana produces many of the same toxins and carcinogens as tobacco smoke, yet the lung health consequences appear markedly different. The consistent finding across studies is that regular marijuana smoking causes symptoms of chronic bronchitis — cough, increased sputum production, wheezing — and visible changes to airway tissue (histopathologic changes in the epithelium).

Cannabis donation as a harm reduction strategy: a case study.

Duhart Clarke, Sarah E · 2024

Ten cannabis-experienced harm reduction clients received weekly cannabis donations, with clinical staff determining appropriateness.

A Survey Study of Individuals Using Hexahydrocannabinol Cannabis Products: Use Patterns and Perceived Effects.

Ferretti, Morgan L · 2024

HHC users reported using approximately 10 days in the past month.

CB1 Receptor Negative Allosteric Modulators as a Potential Tool to Reverse Cannabinoid Toxicity.

Flavin, Audrey · 2024

Three CB1 NAMs (ABD1085, RTICBM189, PSNCBAM1) blocked JWH018 effects in cultured neurons.

"Smoking weed it gets you over the hump": Cannabis co-use as a facilitator of decreased opioid use among people who inject drugs in Los Angeles, California.

Ganesh, Siddhi S · 2024

Three themes emerged for how cannabis co-use facilitated reduced opioid use: (1) maintaining opioid cessation and treatment adherence by managing cessation-specific symptoms, (2) managing episodic opioid withdrawal symptoms, and (3) decreasing opioid use because cannabis was more easily accessible than opioids.

"I don't need my kid to be high": prioritizing harm reduction when using cannabis during pregnancy.

Gould, Erin E · 2024

Three themes emerged for how pregnant cannabis users modified their behavior: (1) changing the amount of cannabis used (reducing frequency or quantity), (2) changing types of products (switching from smoking to edibles, topicals, or lower-THC products), and (3) changing procurement sources (seeking regulated dispensaries over illicit sources).

Use of cannabis to manage symptoms of mental and physical health conditions during pregnancy: analysis of a pro-cannabis pregnancy forum.

Gunn, Rachel L · 2024

Analysis of 120 posts from a pro-cannabis pregnancy forum identified four themes: cannabis for mental health symptoms (depression, anxiety), physical symptoms (nausea, pain), achieving homeostasis and stress management, and decision-making about cannabis versus prescription medications..

Reducing the harms of cannabis use in youth post-legalization: insights from Ontario youth, parents, and service providers.

Kourgiantakis, Toula · 2024

Two themes emerged around perceived harms: concerns about addiction, brain development, motivation, and mental health impacts; and minimization of risks through conflicting messages, normalization, and perceptions of cannabis as less harmful than other substances.

Effect of recreational cannabis use on bone mineral density: a systematic review.

Magno, Luiz Alexandre Viana · 2024

Of four included studies (3 cross-sectional, 1 RCT) covering 4,032 participants, two found that cannabis exposure decreased bone mineral density while two found no effect..

Cannabinoid for alcohol use disorder.

Marquez, Júlia Dalfovo · 2024

The endocannabinoid system, particularly CB1 and CB2 receptors, modulates the brain's reward circuitry for alcohol.

Asystole in a young child with tetrahydrocannabinol overdose: a case report and review of literature.

Masilamani, Mats Steffi Jennifer · 2024

A 7-year-old who ate five 15mg delta-8-THC gummies experienced 15-second asystole with apnea 7 hours after ingestion, despite being clinically stable.

Interpersonal Influences on the Choice to Treat Nausea during Pregnancy with Medication or Cannabis.

Mercer, Amanda H · 2024

Four stakeholder groups influenced treatment decisions: medical providers, partners, family, and friends.

Mitigating the Risk of QTc Prolongation When Using Haloperidol for Acute Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents and Young Adults.

Merino, Sandra · 2024

A 15-year-old with CHS developed QTc prolongation to 528 msec with hypokalemia and hypomagnesemia during haloperidol treatment.

Evaluation of the immune system status and hematological dyscrasias, among amphetamine and cannabis abusers at Eradah Hospital in Qassim, Saudi Arabia.

Mohammed, Amal Hussain · 2024

Significant changes (p<0.001) were found in all leukocyte types including neutrophils, lymphocytes, monocytes, eosinophils, and basophils.

Feasibility and acceptability of a web-intervention to prevent alcohol and cannabis-impaired driving among adolescents in driver education.

Nameth, Katherine · 2024

In user testing with 8 adolescents, 88% would recommend the tool to a friend and 88% reported learning helpful skills.

Urgent need for treatment addressing co-use of tobacco and cannabis: An updated review and considerations for future interventions.

Nguyen, Nhung · 2024

Across 9 studies, combined psychosocial strategies (CBT, motivational interviewing, contingency management) with pharmacotherapy (nicotine replacement) showed promise.

From Chronic Cannabis to Cyclic Chaos: A Glimpse Into Cannabinoid Hyperemesis Syndrome.

Oraibi, Omar · 2024

A 38-year-old male with known cannabis use had cyclic vomiting initially diagnosed as other GI conditions.

Trips Through the Skin: Reviewing Cutaneous Drug Reactions to Psychedelics and Hallucinogens.

Rahman, Syed Minhaj · 2024

Of 22 studies meeting inclusion criteria (40 total patients), cannabis accounted for 10 studies.

Protonitazene detection in two cases of opioid toxicity following the use of tetrahydrocannabinol vape products in Australia.

Syrjanen, Rebekka · 2024

Two young males experienced opioid toxicity after using what they believed were THC vape products.

Unexpected cause of recurrent diabetic ketoacidosis in type 1 diabetes: a case report.

Alduraibi, Rabia Khalid · 2023

The patient experienced 6 DKA episodes in one year with persistent GI symptoms even after DKA resolved.

From Euphoria to Emergency: Exploring the Role of K2/Spice in Diffuse Alveolar Hemorrhage.

Allena, Nishant · 2023

The patient presented with hemoptysis (coughing up blood) after smoking K2/Spice.

Abuse of Synthetic Cannabinoids and Cathinones in a Patient on Buprenorphine-Naloxone Treatment: A Case Report.

Awasthi, Harshal · 2023

The patient was unknowingly consuming synthetic cannabinoids and cathinones in a K2 blend while on buprenorphine/naloxone treatment.

Translating the lived experience of illicit drinkers into program guidance for cannabis substitution: Experiences from the Canadian Managed Alcohol Program Study.

Bailey, Aaron · 2023

The collaboration between researchers, clinicians, and organizations of people with lived experience produced tailored client-facing and provider-facing cannabis education resources.

Prevention, Practice, and Policy: Older US Veterans' Perspectives on Cannabis Use.

Bobitt, Julie · 2023

Semi-structured interviews with 32 older veterans revealed they used medical cannabis as an adjunct or substitute for opioids and benzodiazepines for physical and mental health conditions.

Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study.

Ceasar, Rachel Carmen · 2023

Interviews with 10 maternal health providers revealed three patterns: relying on self-education due to lack of formal training, taking case-by-case approaches rather than following standardized protocols, and actively avoiding cannabis discussions to maintain patient alliances.

PM2.5 exposure to marijuana smoke on golf courses and other public outdoor locations: A pilot observational study.

Cheng, Kai-Chung · 2023

Across 24 visits to 10 golf courses, over 20% of visits encountered marijuana smoke, with peak PM2.5 exposures reaching 149 micrograms per cubic meter.

Bridging the gap between genetic epidemiological research and prevention: A randomized control trial of a novel personalized feedback program for alcohol and cannabis use.

Choi, Maia · 2023

Among 251 first-year college students randomized to four groups, those receiving the Personalized Feedback Program (PFP) showed significant reductions in cannabis use compared to other groups.

"I still partly think this is bullshit": A qualitative analysis of cannabinoid hyperemesis syndrome perceptions among people with chronic cannabis use and cyclic vomiting.

Collins, Alexandra B · 2023

Twenty-four participants with chronic cannabis use and cyclic vomiting attributed their symptoms to food, alcohol, stress, and GI issues rather than cannabis.

Delta-8 tetrahydrocannabinol: a scoping review and commentary

LoParco, Cassidy R. · 2023

Delta-8 THC exists in a remarkable regulatory gray zone.

Cannabinoid Hyperemesis Syndrome in a 23-Year-Old Woman with Uncontrolled Type 1 Diabetes Mellitus.

Nana Sede Mbakop, Raissa · 2023

The patient presented monthly to the ER for two years with intractable nausea and vomiting, managed as diabetic gastroparesis despite a normal gastric emptying study.

Consumer perception, knowledge, and uses of cannabidiol.

Nguyen, Cambrey · 2023

Among 1,158 respondents (median age 43, 50% female), CBD was used for neurological disorders, pulmonary conditions, GI disorders, and chronic pain.

Recurrent Severe Burns Due to Cannabinoid Hyperemesis Syndrome.

Osagie, Eugene · 2023

A chronic daily cannabis user with CHS engaged in compulsive hot bathing, leading to repeated severe burns, sepsis, and ICU stays.

A Case of a Patient With Cannabis Hyperemesis Syndrome Along With Recurrent Nephrolithiasis.

Patel, Maitree · 2023

A 28-year-old American Indian male with daily cannabis use and CHS presented with recurrent renal stones.

Identification of 5F-Cumyl-PINACA, a Synthetic Cannabinoid, in the Herbal Material Used for Recreational Purposes in the Province of Trieste: Public Health Implications.

Peruch, Michela · 2023

The product tested negative for THC but positive for 5F-Cumyl-PINACA at a dose of 8.5 mg per package.

Effects of the cannabinoid CB1-receptor neutral antagonist AM4113 and antagonist/inverse agonist rimonabant on fentanyl discrimination in male rats.

AlKhelb, Dalal · 2022

AM4113 (0.32-1.0 mg/kg) effectively blocked fentanyl discrimination at doses that did not reduce food-maintained responding.

Alleviation of opioid withdrawal by cannabis and delta-9-tetrahydrocannabinol: A systematic review of observational and experimental human studies.

De Aquino, Joao P · 2022

Of 11 studies with 5,330 participants, four observational studies found cannabis use was associated with reduced opioid withdrawal, one found worsening symptoms, and four found no association.

Management of Hyperhomocysteinemia, Low Vitamin Levels, and Low Cortisol in Cannabis Users: A Report of 2 Cases.

de Carvalho, Jozélio · 2022

Both patients, who had used cannabis for 9 and 14 years respectively, had abnormal blood levels of homocysteine, vitamins, and cortisol.

Cannabidiol Interferes with Establishment of Δ9-Tetrahydrocannabinol-Induced Nausea Through a 5-HT1A Mechanism.

DeVuono, Marieka V · 2022

CBD (5 mg/kg) blocked the establishment of THC-induced conditioned gaping (a measure of nausea) in rats, and this effect was reversed by a 5-HT1A receptor antagonist (WAY-100635).

The Cannabinoid Receptor Type 1 Positive Allosteric Modulator ZCZ011 Attenuates Naloxone-Precipitated Diarrhea and Weight Loss in Oxycodone-Dependent Mice.

Dodu, Julien C · 2022

ZCZ011 completely eliminated naloxone-precipitated diarrhea and weight loss in oxycodone-dependent mice and reduced paw flutters by about half.

Drivers of purchase decisions for cannabis products among consumers in a legalized market: a qualitative study.

Donnan, Jennifer · 2022

Among 23 cannabis consumers in Newfoundland and Labrador, five themes drove purchase decisions: price, quality, packaging/warnings, source, and social influences.

Patient caught breastfeeding and instructed to stop: an empirical ethics study on marijuana and lactation.

Gross, Marielle S · 2022

Medical records revealed punitive language like "patient caught breastfeeding and instructed to stop." While plausible harms from breastmilk THC exposure exist, evidence of actual infant effects is limited and confounded.

Clinician views on and ethics priorities for authorizing medical cannabis in the care of children and youth in Canada: a qualitative study.

Gunning, Margot · 2022

Four themes emerged: access challenges, relational autonomy (shared decision-making between clinicians, patients, and families), medically appropriate use, and research priorities.

Healthcare practitioner perceptions on barriers impacting cannabis prescribing practices.

Hachem, Yasmina · 2022

Only 6% received medical cannabis training in professional school, though 60% had other training.

Pneumomediastinum and Pneumorrhachis Associated With Cannabinoid Hyperemesis Syndrome.

Hernandez Garcia, Laura R · 2022

This is the third reported case of CHS with associated pneumomediastinum and the first documented case of pneumorrhachis (air in the spinal canal) linked to CHS.

Cannabis, cannabidiol and tetrahydrocannabinol in sport: an overview.

Kennedy, Michael · 2022

CBD and THC do not enhance performance.

An Observational Cross-Sectional Survey Exploring the Indications for and Responses to Medical Marijuana Use in Certified Patients in Pennsylvania.

Kimless, Debra · 2022

Anxiety disorder was the most common qualifying condition (50.1%) and comorbid condition (69.3%).

Clinical features associated with ADB-BUTINACA exposure in patients attending emergency departments in England.

King, A · 2022

ADB-BUTINACA was found in 10 of 1,279 patients in the IONA study, all since February 2021, suggesting recent emergence.

"Ganja Mamas": Online discussions about cannabis use in pregnancy.

Lebron, Cynthia N · 2022

Analysis of 151 messages and 1,260 comments from a pregnancy cannabis forum found that testing and child protective services were the top concerns, with members actively interviewing each other about geographic-specific experiences..

A Survey of Topical Cannabis Use in Canada.

Mahmood, Farhan · 2022

Among survey respondents, 24.3% had used cannabis topically at least once.

Protective Behavioural Mechanisms Against Cannabis Use Among Adolescents in Cannabis-Growing Settings of South Africa: Insights Into Adolescent Cannabis Use Prevention.

Manu, Emmanuel · 2022

Nine behavioral protective mechanisms were identified: intrinsically, determination to avoid bad behaviors, academic focus, financial independence from cannabis-using peers, desire for good marriages, and religious beliefs.

Safety and Tolerability of Oral Cannabinoids in People Living with HIV on Long-Term ART: A Randomized, Open-Label, Interventional Pilot Clinical Trial (CTNPT 028).

Mboumba Bouassa, Ralph-Sydney · 2022

Eight of ten HIV-positive participants completed 12 weeks of treatment.

"I got a bunch of weed to help me through the withdrawals": Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums.

Meacham, Meredith C · 2022

Cannabis-related posts were twice as prevalent in the recovery subreddit (5.4%) as in the active opioid use subreddit (2.6%).

Real-Time Monitoring of Cannabis and Prescription Opioid Co-Use Patterns, Analgesic Effectiveness, and the Opioid-Sparing Effect of Cannabis in Individuals With Chronic Pain.

Mun, Chung Jung · 2022

Using 30-day ecological momentary assessment, neither cannabis-opioid co-use nor sole use of either substance reduced pain in the next moment.

Effects of synthetic (JWH-018) cannabinoids treatment on spermatogenesis and sperm function.

Mutluay, Duygu · 2022

JWH-018 (0.3 mg/kg for 9 days) caused significantly decreased sperm concentration, motility, and membrane integrity, reduced testosterone, increased abnormal sperm morphology, and seminiferous tubule degeneration.

Cannabinoid Hyperemesis Syndrome and Hypophosphatemia in Adolescents.

Nachnani, Rahul · 2022

Three adolescents with CHS developed recurrent hypophosphatemia (low phosphorus) that complicated their hospitalizations.

Fine Particulate Matter Exposure From Secondhand Cannabis Bong Smoking.

Nguyen, Patton Khuu · 2022

The study quantified PM2.5 levels from secondhand cannabis bong smoke in a residential setting, demonstrating that bystanders are exposed to fine particulate matter during social smoking sessions..

Cannabinoid Hyperemesis Syndrome Survey and Genomic Investigation.

Russo, Ethan B · 2022

CHS patients showed significantly elevated mutations in COMT (OR 12.0), ABCA1 (OR 8.4), CYP2C9 (OR 7.8), DRD2 (OR 6.2), and TRPV1 (OR 5.8) compared to cannabis-using controls without CHS.

Is Cannabis Legalization Eliciting Abusive Behaviors in Parents? A Case Report.

Russo, Marianna · 2022

A 4-year-old with anti-NMDA receptor encephalitis tested positive for cannabis and other substances during investigation of treatment-resistant behavioral disturbances.

A Case Report on Cannabinoid Hyperemesis Syndrome in Palliative Care: How Good Intentions Can Go Wrong.

Senderovich, Helen · 2022

A 70-year-old palliative care patient with small-cell lung cancer who had used nabilone for 5 years developed refractory nausea and vomiting consistent with cannabinoid hyperemesis syndrome.

A randomized pilot trial of a mobile phone-based brief intervention with personalized feedback and interactive text messaging to reduce driving after cannabis use and riding with a cannabis impaired driver.

Teeters, Jenni B · 2022

College cannabis users in the personalized feedback plus MI-style interactive text messaging condition significantly reduced driving after cannabis use (DACU) and riding with a cannabis-impaired driver (RWCD) over 3 months compared to information control..

Factor-guided diagnosis of coagulopathy associated with coumarin-contaminated synthetic cannabinoids.

Torian, Sterling C · 2022

A young adult presented with elevated INR without known medical history.

Cannabis edibles packaging: Communicative objects in a growing market.

Ventresca, Matt · 2022

Participants discussed four main themes: dosage/consumption recommendations, food/nutritional information, concerns for children, and health warnings.

A Case of Presumed Bonsai-induced Severe Toxic Optic Neuropathy.

Yasar, Erdogan · 2022

The patient presented with severely decreased vision in both eyes.

Δ8-THC: Legal Status, Widespread Availability, and Safety Concerns.

Babalonis, Shanna · 2021

Delta-8 THC products are widely available without regulation despite being classified as Schedule I by the DEA.

Medication and substance use increases among people using cannabis medically during the COVID-19 pandemic.

Boehnke, Kevin F · 2021

Over half of 353 medical cannabis users either started or increased use of other medications/substances during COVID-19, most commonly alcohol and sleep aids.

Cannabis Use and Nonfatal Opioid Overdose among Patients Enrolled in Methadone Maintenance Treatment.

Bryson, William C · 2021

Nonfatal opioid overdose prevalence was 3% among frequent cannabis users vs 9% among infrequent/non-users (p=0.02).

A Reason to Rethink Fasting Guidelines? Marijuana-Induced Gastroparesis and the Implications for Aspiration Risk in the Nil Per Os (NPO) Patient: A Case Report.

Cammarano, Caitlin A · 2021

Despite standard fasting (last meal at 10 PM the prior night), a daily cannabis user had 150 cc of gastric contents fill the airway device upon anesthesia induction, with 500 cc total suctioned from the stomach.

Factors associated with health-related cannabis use intentions among a community sample of people who inject drugs in Los Angeles and San Francisco, CA 2016 to 2018.

Ceasar, Rachel Carmen · 2021

Cannabis use for physical pain relief was associated with higher odds of using cannabis as an opioid substitute.

Urinary Cannabis Metabolite Concentrations in Cannabis Hyperemesis Syndrome.

Cordova, Jonathan · 2021

14 of 15 CHS patients had urinary THC-COOH concentrations above 100 ng/mL, with 7 exceeding 500 ng/mL.

Gabapentin attenuates somatic signs of precipitated THC withdrawal in mice.

Eckard, M L · 2021

Gabapentin (10+ mg/kg) reduced paw tremors and head twitches during rimonabant-precipitated THC withdrawal.

Cannabis Use Among Mental Health Professionals: A Qualitative Study of Cannabis-Related Risk Perceptions.

Ghelani, Amar · 2021

Mental health professionals who use cannabis identified multiple risks from both personal and clinical experience: anxiety, relational challenges, impaired driving, psychosis, cognitive impairment, educational/employment dysfunction, and addiction in some users.

Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes.

Kaczor, Eric E · 2021

Pediatric edible cannabis exposures increased five-fold after Massachusetts recreational dispensaries opened.

Cognitive and affective responses to marijuana prevention and educational messaging.

Leshner, Glenn · 2021

Driving-themed prevention messages from two different campaigns consistently produced the greatest cognitive resource allocation, highest arousal, and most positive emotional responses, as measured by heart rate, skin conductance, and facial action coding..

Case Report: CBD Cigarettes for Harm Reduction and Adjunctive Therapy in a Patient With Schizophrenia and Substance Use Disorder.

Meyer, Maximilian · 2021

After years of treatment failure with 30 hospitalizations, introducing CBD cigarettes (<1% THC) as adjunctive therapy, combined with off-label methylphenidate, led the patient to report significantly less need for illegal high-THC cannabis.

"If I knew I could get that every hour instead of alcohol, I would take the cannabis": need and feasibility of cannabis substitution implementation in Canadian managed alcohol programs.

Pauly, Bernie · 2021

63% of MAP participants reported already substituting cannabis for alcohol, most often weekly (42%), primarily for alcohol cravings (79%) and withdrawal (53%).

Topical capsaicin for the treatment of cannabinoid hyperemesis syndrome, a systematic review and meta-analysis.

Pourmand, Ali · 2021

Across 7 included studies (106 patients), topical capsaicin appeared effective for CHS symptom relief.

A mobile phone-based brief intervention with personalized feedback and interactive text messaging is associated with changes in driving after cannabis use cognitions in a proof-of-concept pilot trial.

Teeters, Jenni B · 2021

Compared to an informational control, participants who received personalized feedback plus interactive text messaging (PFT) showed significantly greater increases in perceived dangerousness of driving after cannabis use at 3-month follow-up, though personalized feedback alone (PF) was not significantly different from control..

Efficacy of topical capsaicin for the treatment of cannabinoid hyperemesis syndrome: A retrospective cohort study.

Yusuf, Hamzah M · 2021

No overall difference in time to discharge between capsaicin (4.46 hours) and no capsaicin (3.52 hours) groups.

Cannabinoid CB2 Receptor Activation Attenuates Fentanyl-Induced Respiratory Depression.

Zavala, Carmen A · 2021

Co-administration of LY2828360 (3 mg/kg) with fentanyl (0.2 mg/kg) attenuated respiratory depression in wild-type mice but not CB2 knockout mice, confirming the effect was CB2-mediated.

Vaping-associated lung injury caused by inhalation of cannabis oil.

Abeles, Michael · 2020

The case documented severe acute lung injury secondary to inhalation of cannabis oil via a vape pen.

Cannabis Vaping-Induced Acute Pulmonary Toxicity: Case Series and Review of Literature.

Adapa, Sreedhar · 2020

Literature review identified cases of acute respiratory failure from vaping cannabis oil.

Self-reported Secondhand Marijuana Smoke (SHMS) Exposure in Two New York City (NYC) Subsidized Housing Settings, 2018: NYC Housing Authority and Lower-Income Private Sector Buildings.

Anastasiou, Elle · 2020

67% of residents reported smelling marijuana smoke in their home over the past year, compared to 60% for cigarette smoke.

Uses, Effects and Toxicity of Synthetic Cannabinoids from the Perspective of People with Lived Experiences.

Assi, Sulaf · 2020

Content analysis of 1,660 posts from 50 threads (2004-2016) revealed significant information exchange about SC consumption characteristics, modalities of use, experienced effects, and toxicity.

A Case of Toxicity from Cannabidiol Gummy Ingestion.

Bass, Jessica · 2020

After consuming 370mg of CBD gummies (from two packages, well above the 30mg serving size), the patient developed slurred speech, vomiting, respiratory depression (O2 sat 78-84%), sinus bradycardia (HR 47), and hypotension (BP 88/52).

Comparison of the Neurotoxic and Seizure-Inducing Effects of Synthetic and Endogenous Cannabinoids with Δ9-Tetrahydrocannabinol.

Breivogel, Chris S · 2020

JWH-073 and AM-2201 produced significantly more convulsions than THC, HU-210, methanandamide, or CBD.

Acute eosinophilic pneumonia associated with non-cigarette smoking products: a systematic review.

Chaaban, Toufic · 2020

Twelve cases were identified: 5 from marijuana, 2 from waterpipe, 2 from e-cigarettes, 2 from heat-not-burn cigarettes, and 1 from synthetic cannabinoids.

Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis.

Cheng, Phoebe · 2020

Of 911 total poisonings, 114 (12.5%) were cannabis-related.

Cannabinoid hyperemesis syndrome: A case study and discussion.

Creedon, Eliza S · 2020

CHS symptoms include cyclical nausea, vomiting, and abdominal pain in chronic cannabis users, often relieved by compulsive hot bathing.

A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome.

Dean, Diana J · 2020

At 60 minutes, mean nausea severity was 3.2 cm (capsaicin) vs.

Nausea-Induced Conditioned Gaping Reactions in Rats Produced by High-Dose Synthetic Cannabinoid, JWH-018.

DeVuono, Marieka V · 2020

JWH-018 at 1 and 3 mg/kg produced conditioned gaping (nausea).

Role of the stress response and the endocannabinoid system in Δ9-tetrahydrocannabinol (THC)-induced nausea.

DeVuono, Marieka V · 2020

Antalarmin (CRH antagonist), MJN110 (2-AG elevator), URB597 (AEA elevator), propranolol, WAY-100635, and chlordiazepoxide all blocked THC-induced conditioned gaping.

Vaping-Associated Acute Respiratory Failure Due to Acute Lipoid Pneumonia.

Dicpinigaitis, Peter V · 2020

A healthy 28-year-old developed acute respiratory failure 2 weeks after using a street-purchased THC vape cartridge.

Characteristics of Dispensary Patients that Limit Alcohol after Initiating Cannabis.

Hayat, Assad · 2020

Alcohol abaters and non-abaters did not differ in age, sex, or prior drug history.

Unintentional use of fentanyl attributed to surreptitious cannabis adulteration.

Hopwood, Taylor · 2020

A patient receiving buprenorphine for opioid use disorder repeatedly tested positive for fentanyl on urine drug screens while denying opioid use but admitting to smoking street cannabis 2-3 times weekly.

Small bowel intussusception in marijuana users.

Kakish, Daniel · 2020

Eleven patients, all heavy marijuana users, presented with small bowel intussusception at a single institution.

Safety and Molecular-Toxicological Implications of Cannabidiol-Rich Cannabis Extract and Methylsulfonylmethane Co-Administration.

Kutanzi, Kristy R · 2020

Researchers gave mice a high-dose cannabidiol-rich cannabis extract (CRCE) alongside methylsulfonylmethane (MSM), a popular over-the-counter supplement often taken for joint pain.

Cannabis-induced recurrent myocardial infarction in a 21-year-old man: a case report.

Lawin, Dennis · 2020

A 21-year-old man with no cardiovascular risk factors experienced four acute coronary syndrome events over 18 months, each involving thrombotic coronary artery occlusion requiring intervention.

Delta-9 THC can be detected and quantified in the semen of men who are chronic users of inhaled cannabis.

Lee, Malinda S · 2020

Among 12 heavy cannabis users, THC was detectable above reporting levels (0.50 ng/mL) in 2 of 10 analyzable semen samples.

Cannabis Use During Lactation: Literature Review and Clinical Recommendations.

Ordean, Alice · 2020

Despite cannabis being the most commonly used psychoactive substance by 5% of Canadian postpartum women, only two studies met inclusion criteria for developmental outcomes in breastfed infants exposed to cannabis.

Cannabis and Radiation Therapy: A Scoping Review of Human Clinical Trials.

Rosewall, Tara · 2020

Of 48 records screened, only 8 clinical studies met criteria.

Efficacy and safety of topical capsaicin for cannabinoid hyperemesis syndrome in the emergency department.

Wagner, Samantha · 2020

ED length of stay was reduced by a median of 22 minutes with capsaicin but this was not statistically significant.

Systemic administration with tetrahydrocannabinol causes retinal damage in BALB/c mice.

Zhang, Z · 2020

THC at 1-2 mg/kg daily for 2 months caused functional loss on electroretinography, increased photoreceptor cell apoptosis, elevated inflammatory markers (TNF-alpha, IL-1beta, IL-6), and increased oxidative stress markers in retinal tissue.

Synthetic Cannabinoid-Associated Multiple Organ Failure: Case Series and Literature Review.

Armstrong, Faith · 2019

All six patients had altered mental status and severe rhabdomyolysis (peak CK up to >320,000 U/L).

Disseminated Intravascular Coagulopathy Secondary to Unintentional Brodifacoum Poisoning via Synthetic Marijuana.

Chan, Abigail · 2019

The patient developed severe coagulopathy and cardiac arrest after synthetic cannabinoid use contaminated with brodifacoum.

Caring for people with multiple sclerosis who use cannabis for symptom control.

Daly, Laura · 2019

A large proportion of people with MS use cannabis to self-manage symptoms or believe in its potential benefits.

Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain.

De Ternay, Julia · 2019

In animal models, CBD reduced overall alcohol drinking by decreasing ethanol intake, motivation for ethanol, relapse, anxiety, and impulsivity.

Marijuana-Derived Cannabinoids Trigger a CB2/PI3K Axis of Suppression of the Innate Response to Oral Pathogens.

Gu, Zhen · 2019

All three major phytocannabinoids (CBD, CBN, THC) at physiological doses suppressed pro-inflammatory cytokine release (IL-12, IL-6, IL-8, TNF) and enhanced anti-inflammatory IL-10 in response to three oral pathogens.

Cannabis Hyperemesis Syndrome in Palliative Care: A Case Study and Narrative Review.

Howard, Ileana · 2019

In a palliative care patient with advanced ALS, cannabis hyperemesis presented atypically without the classic hot bath behavior (due to physical disability).

ST elevation myocardial infarction following a cannabis smoking binge.

Katranas, Sotirios · 2019

A 26-year-old male with no prior cardiac history presented with ST-elevation myocardial infarction and subsequent heart failure after heavy cannabis smoking.

A cross-sectional examination of choice and behavior of veterans with access to free medicinal cannabis.

Loflin, Mallory J E · 2019

The majority of veterans reported using cannabis as a substitute for prescription medications, alcohol, tobacco, or illicit substances.

Marijuana as a Substitute for Prescription Medications: A Qualitative Study.

Mercurio, Alana · 2019

Three key themes emerged: (1) patients perceived cannabis as having fewer/better side effects and improving quality of life versus prescriptions, (2) patients used cannabis to supplement or replace other medications including opioids, and (3) stigma, travel restrictions, cost, and inability of providers to give dosing/strain guidance significantly limited use..

Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases.

Nourbakhsh, Mahra · 2019

A 27-year-old female, 27-year-old male, and 31-year-old male with histories of cyclical nausea, vomiting, chronic cannabis use, and negative workups all died.

Emerging Role of Aprepitant in Cannabis Hyperemesis Syndrome.

Parvataneni, Swetha · 2019

A patient with CHS who did not respond to common anti-emetics was successfully treated with aprepitant, an NK1 receptor antagonist typically used for chemotherapy-induced nausea..

Indoor cannabis smoke and children's health.

Posis, Alexander · 2019

Homes with indoor cannabis smoking had higher air particle concentrations than those with cigarette smoking alone (3,131 vs.

Denying renal transplantation to an adolescent medical cannabis user: An ethical case study.

Ryan, Jennie E · 2019

A 20-year-old woman recommended for renal transplant was originally denied active listing because of her medical cannabis use.

Surface Detection of THC Attributable to Vaporizer Use in the Indoor Environment.

Sempio, Cristina · 2019

THC was detected on 6 of 15 surface samples collected from a room where cannabis was vaporized, at quantifiable levels of 348-4,882 ng/m2.

Emergency Department and Radiological Cost of Delayed Diagnosis of Cannabinoid Hyperemesis.

Zimmer, David I · 2019

Patients averaged 17.9 ED visits before cannabinoid hyperemesis was diagnosed.

Pseudo-Wellens' syndrome secondary to concurrent cannabis and phencyclidine intoxication.

Inayat, Faisal · 2018

A patient arrived with atypical left chest pain and dizziness that started 6 hours after smoking phencyclidine (PCP)-laced cannabis. The ECG showed new deep biphasic T-wave inversions in anterolateral leads, a pattern characteristic of Wellens' syndrome, which typically indicates critical blockage of the left anterior descending artery and imminent heart attack risk. However, troponin levels were normal and coronary angiography revealed no coronary artery disease.

Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice.

Kast, Kristopher A · 2018

A patient with cannabinoid hyperemesis syndrome was initially misdiagnosed, requiring psychiatric consultation for proper identification. CHS involves cyclic episodes of severe nausea and vomiting in chronic cannabis users, often with compulsive hot bathing for symptom relief.

Recurrent Nausea and Vomiting in a Pregnant Woman with Chronic Marijuana Use.

Kim, Hyunyoung G · 2018

A 20-year-old pregnant woman was admitted multiple times for recurrent nausea and vomiting.

Cannabinoid Hyperemesis Syndrome Masquerading as Uremia: An Educational Case Report.

Klassen, Judith · 2018

A 37-year-old man with bipolar disorder (treated with lithium) had progressive renal insufficiency from interstitial fibrosis.

A case of cannabinoid hyperemesis syndrome with Heliobacter pylori and preeclampsia during pregnancy.

Manning Meurer, Madeline · 2018

A 21-year-old first-time pregnant woman was diagnosed with hyperemesis gravidarum at 6 weeks and later developed preeclampsia at 35 weeks. A drug screen at 30 weeks was positive for cannabis, leading to a CHS diagnosis that had been masked by pregnancy-related nausea. After labor induction, the infant was born with a negative umbilical cord drug test and developed normally. Post-delivery endoscopy revealed moderate chronic gastritis with H.

Impaired Driving Associated with the Synthetic Cannabinoid 5f-Adb.

McCain, K R · 2018

Law enforcement witnessed erratic driving by a 45-year-old male in fall 2017.

Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin.

Moon, Andrew M · 2018

A patient with cannabinoid hyperemesis syndrome experienced symptom improvement after topical capsaicin application. The authors proposed a novel mechanistic model: chronic cannabis use decreases signaling through the transient receptor potential vanilloid subtype 1 (TRPV1) receptor, which alters gastric motility and triggers the nausea/vomiting cycle. This model explains the previously puzzling observation that CHS patients compulsively seek hot baths: both hot water and capsaicin activate TRPV1 receptors, temporarily restoring the signaling that chronic cannabis has dampened. Previous models focused solely on CB1 receptor derangement, but the TRPV1 model fills gaps in understanding, including why hot bathing provides relief and why the syndrome develops only in some chronic users (who may have different baseline TRPV1 sensitivity)..

A Qualitative Investigation Comparing Psychosocial and Physical Sexual Experiences Related to Alcohol and Marijuana Use among Adults.

Palamar, Joseph J · 2018

Twenty-four adults who recently used marijuana before sex were interviewed about how alcohol and marijuana differently affected their sexual experiences. Alcohol effects: facilitated social connections and meeting sexual partners, but was more likely to lead to atypical partner choices (someone they would not normally choose) and feelings of regret after sex.

Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment.

Richards, John R · 2018

Capsaicin and hot water both activate TRPV1 receptors, which share extensive cross-talk with the endocannabinoid system.

Medicinal cannabis (Bedrolite) substitution therapy in inpatients with a psychotic disorder and a comorbid cannabis use disorder: A case series.

Schipper, Regi · 2018

The low-THC medicinal cannabis variant Bedrolite was not effective in treating inpatients with psychotic disorders and comorbid cannabis use disorder.

Acceptance of pharmaceutical cannabis substitution by cannabis using patients with schizophrenia.

van Amsterdam, Jan · 2018

Both substitute variants (low THC/no CBD and low THC/high CBD) were appreciated by patients.

Marijuana Use and Self-reported Quality of Eyesight.

Akano, Obinna F · 2017

Comparing 1,304 heavy marijuana users to 1,304 matched light or non-users from the National Longitudinal Survey of Youths, there was no statistically significant difference in self-reported quality of eyesight. Within the heavy marijuana group, some demographic patterns emerged: males and high school graduates had decreased odds of reporting poor eyesight, while Black respondents had increased odds of reporting poor eyesight.

The clinical implications of legalizing marijuana: Are physician and non-physician providers prepared?

Brooks, Elizabeth · 2017

A survey of 114 Colorado healthcare providers who care for children, adolescents, pregnant women, and breastfeeding women found that about half of those working with adolescents and pregnant/breastfeeding women assessed marijuana use at every or most visits.

Hypophosphatemia in Users of Cannabis.

Cadman, Peter E · 2017

Between 2011 and 2014, six men treated for cannabinoid hyperemesis syndrome (CHS) at a VA Medical Center were found to have significant hypophosphatemia, with phosphate levels ranging from less than 1.0 to 1.3 mg/dL (normal: 2.5-4.5 mg/dL). In three patients, phosphate levels normalized spontaneously within hours without supplementation, suggesting redistribution of phosphate between compartments rather than true depletion.

Pharmaco-toxicological effects of the novel third-generation fluorinate synthetic cannabinoids, 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice. In vitro and in vivo studies.

Canazza, Isabella · 2017

In vitro testing revealed that all three synthetic cannabinoids (5F-ADBINACA, AB-FUBINACA, STS-135) had nanomolar affinity for both mouse and human CB1 and CB2 receptors, making them far more potent than THC.

Cannabinoid Poisoning by Hemp Seed Oil in a Child.

Chinello, Matteo · 2017

A preschool child was prescribed hemp seed oil by a pediatrician to strengthen the immune system.

Second and Thirdhand Smoke Exposure, Attitudes and Protective Practices: Results from a Survey of Hispanic Residents in Multi-unit Housing.

Delgado-Rendon, Angelica · 2017

Although 97% of surveyed Hispanic tenants banned smoking inside their own apartments, 80% still reported tobacco secondhand smoke (SHS) infiltrating from other units within the past year.

Resolution of cannabis hyperemesis syndrome with topical capsaicin in the emergency department: a case series.

Dezieck, Laurel · 2017

Thirteen patients with daily cannabis use and symptoms consistent with cannabinoid hyperemesis syndrome (CHS) were treated with topical capsaicin cream at two academic medical center emergency departments.

Marijuana use in acute coronary syndromes.

Draz, Eman I · 2017

Among 138 young men (age 40 or under) admitted with acute heart attacks, 23 tested positive for cannabis only.

Cannabinoid Hyperemesis Syndrome.

Fleming, J Eric · 2017

The review from a federal healthcare publication emphasized that cannabinoid hyperemesis syndrome (CHS) sits at the intersection of three converging trends: legislative efforts expanding cannabis access, increasing prevalence of cannabis use, and rising THC potency.

Conservative treatment of patients with thromboangiitis obliterans or cannabis-associated arteritis presenting with critical lower limb ischaemia.

Galyfos, George · 2017

Over six years, 23 patients (15 with thromboangiitis obliterans and 8 with cannabis-associated arteritis) presented with critical lower limb ischemia.

Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents: A Case Series.

Graham, Jessica · 2017

Two adolescent patients presented to a pediatric emergency department with nausea, vomiting, and abdominal pain in the setting of chronic cannabis use.

Perceived harms and benefits of tobacco, marijuana, and electronic vaporizers among young adults in Colorado: implications for health education and research.

Popova, Lucy · 2017

Through 32 in-depth interviews with young adults aged 18-26 in Denver who used tobacco, marijuana, or vaporizers, researchers identified five dimensions these users applied when evaluating harms and benefits. Combustion: smoking anything was considered more harmful than non-combustible forms (edibles, vaporizers).

Antidote to cannabinoid intoxication: the CB1 receptor inverse agonist, AM251, reverses hypothermic effects of the CB1 receptor agonist, CB-13, in mice.

Pryce, Gareth · 2017

Researchers induced cannabinoid intoxication in mice using the synthetic CB1 agonist CB-13, which caused significant hypothermia and visible sedation.

Haloperidol, a Novel Treatment for Cannabinoid Hyperemesis Syndrome.

Witsil, Joanne C · 2017

Four patients with CHS who failed standard emergency department therapy (including conventional antiemetics) showed significant improvement after treatment with haloperidol, an antipsychotic that primarily blocks dopamine D2 receptors. The authors propose a mechanistic explanation: CHS involves dysregulation of cannabinoid type 1 (CB1) receptors, and recent animal research has revealed complex interactions between dopamine and CB1 signaling.

Cannabis Hyperemesis Syndrome in the Emergency Department: How Can a Specialized Addiction Team Be Useful? A Pilot Study.

Pélissier, Fanny · 2016

Over a seven-month period, a specialized addiction team in a French emergency department identified seven cases of cannabinoid hyperemesis syndrome (CHS) among cannabis users admitted for vomiting or abdominal pain. The patients were young adults (mean age 24.7 years, mostly male).

Efficacy evaluation of the school program Unplugged for drug use prevention among Brazilian adolescents.

Sanchez, Zila M · 2016

Researchers evaluated the Unplugged program, a European school-based drug prevention curriculum, adapted for Brazilian public middle schools.

Accidental cannabis poisoning in the elderly.

Zupan Mežnar, Anja · 2016

During a workshop on hemp's medicinal uses, attendees sampled various hemp food products.

Feasibility of a group cessation program for co-smokers of cannabis and tobacco.

Becker, Julia · 2015

Researchers tested a group cessation program for people who used both cannabis weekly and tobacco daily.

A safer alternative: Cannabis substitution as harm reduction.

Lau, Nicholas · 2015

Researchers conducted in-depth life history interviews with Baby Boomer (born 1946-1964) marijuana users in the San Francisco Bay Area to understand their harm reduction beliefs and substitution practices. Participants described consciously choosing cannabis over alcohol, illicit drugs, and prescription medications.

Cannabis hyperemesis syndrome: A case report review of treatment.

Mahmad, Abdul I · 2015

A 32-year-old man with no significant medical history arrived at the emergency department with five days of nausea, vomiting, and diffuse abdominal pain.

Marijuana and tobacco use and co-use among African Americans: results from the 2013, National Survey on Drug Use and Health.

Montgomery, LaTrice · 2015

Researchers examined 2,024 African American past-month marijuana and tobacco users from the 2013 National Survey on Drug Use and Health.

Allowing cigarette or marijuana smoking in the home and car: prevalence and correlates in a young adult sample.

Padilla, Mabel · 2015

Researchers surveyed 2,002 students at two southeastern U.S.

Inhaled medicinal cannabis and the immunocompromised patient.

Ruchlemer, Rosa · 2015

Researchers addressed a practical safety concern: medical cannabis carries bacteria and fungi on its leaves and flowers that could cause life-threatening infections in immunocompromised patients (such as those undergoing chemotherapy). They cultured cannabis herb to identify contaminants, tested three sterilization methods, and measured how much cannabinoid activity was lost in each process.

Cannabinoid hyperemesis syndrome: an important differential diagnosis of persistent unexplained vomiting.

Ruffle, James K · 2015

Researchers identified 10 cases of cannabinoid hyperemesis syndrome (CHS) at gastroenterology clinics over two years.

How beneficial is vaping cannabis to respiratory health compared to smoking?

Tashkin, Donald P · 2015

This commentary examined whether vaporizing cannabis provides meaningful respiratory health advantages over smoking it.

Analysis of Cannabinoids and Their Metabolites in Human Urine.

Wei, Binnian · 2015

Researchers developed and validated a new method for detecting cannabinoids in urine using ultra-high performance liquid chromatography with tandem mass spectrometry.

A pilot study of an online universal school-based intervention to prevent alcohol and cannabis use in the UK.

Newton, Nicola C · 2014

The Climate Schools program, originally developed and validated in Australia, was piloted in two UK secondary schools with Year 9 students (approximately 13-14 years old).

Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability.

Becker, Julia · 2013

Through expert interviews, focus groups with former smokers, and an online survey, researchers confirmed strong demand for an integrated cessation program targeting both tobacco and cannabis.

Synthetic cannabinoid intoxication: a case series and review.

Harris, Carson R · 2013

Six patients presented to an emergency department over three months after using Spice products.

Haloperidol for treatment of cannabinoid hyperemesis syndrome.

Hickey, Jami L · 2013

A patient with cannabinoid hyperemesis syndrome (CHS), characterized by cyclical vomiting in the setting of chronic cannabis use, was treated with haloperidol in the emergency department.

Cannabinoid hyperemesis syndrome: a case series and review of previous reports.

Nicolson, Stephen E · 2012

The authors described four patients who experienced recurring cycles of intense nausea and vomiting that were linked to long-term, heavy cannabis use.

Screening and managing cannabis use: comparing GP's and nurses' knowledge, beliefs, and behavior.

Norberg, Melissa M · 2012

Researchers surveyed 503 GPs and 161 nurses about their cannabis-related knowledge, beliefs, and clinical behaviors.

Comparison of urine results concerning co-consumption of illicit heroin and other drugs in heroin and methadone maintenance programs.

Musshoff, Frank · 2010

Researchers analyzed urine samples from patients in a heroin maintenance program (HMP) and a methadone maintenance program (MMP) at one month before and 6 and 12 months into treatment. Illicit heroin co-use was detected in 50% of HMP patients, significantly lower than the 71% rate in MMP patients.

Intermittent marijuana use is associated with improved retention in naltrexone treatment for opiate-dependence.

Raby, Wilfrid Noel · 2009

Sixty-three opioid-dependent patients were enrolled in a naltrexone trial and classified by their cannabis use during treatment: abstinent, intermittent, or consistent users. Intermittent cannabis users showed dramatically superior treatment retention: median 133 days compared to just 35 days for both abstinent and consistent cannabis users.

Cannabis as a substitute for alcohol and other drugs.

Reiman, Amanda · 2009

Researchers surveyed 350 patients at a Berkeley, California medical cannabis dispensary about their substance use patterns and substitution behaviors. Substitution was common: 40% had used cannabis as a substitute for alcohol, 26% for illicit drugs, and 66% for prescription drugs. The most frequently cited reasons for substituting cannabis were fewer adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%). The sample was predominantly male (68%), with a mean age of 39.

Marijuana as a trigger of cardiovascular events: speculation or scientific certainty?

Aryana, Arash · 2007

This review compiled case reports and studies from the previous three decades documenting cardiovascular complications associated with marijuana use.

Evaluation of herbal cannabis characteristics by medical users: a randomized trial.

Ware, Mark A · 2006

Eight experienced and authorized medical cannabis users with chronic pain evaluated four different herbal cannabis preparations varied by grind size, THC content, and humidity in a randomized crossover trial at a licensed clinical facility. Seven subjects completed the study.

Reversal of cannabinoids (delta9-THC) by the benzoflavone moiety from methanol extract of Passiflora incarnata Linneaus in mice: a possible therapy for cannabinoid addiction.

Dhawan, Kamaldeep · 2002

Mice given THC (10 mg/kg twice daily for 6 days) along with a benzoflavone compound from Passiflora incarnata developed significantly less tolerance and dependence compared to mice receiving THC alone.

Detection of cannabis in oral fluid (saliva) and forehead wipes (sweat) from impaired drivers.

Kintz, P · 2000

Researchers collected blood, urine, saliva, and forehead sweat simultaneously from 198 injured drivers in Strasbourg, France.

Breastfeeding and the use of recreational drugs--alcohol, caffeine, nicotine and marijuana.

Liston, J · 1998

This review examined the evidence on four commonly used recreational substances and their effects on breastfeeding, combining published research with reports from breastfeeding counselors. All four substances, alcohol, caffeine, nicotine, and marijuana, enter breast milk.

Possible risk of invasive pulmonary aspergillosis with marijuana use during chemotherapy for small cell lung cancer.

Sutton, S · 1986

A patient with small cell lung cancer was using illegally obtained marijuana to control nausea during combination chemotherapy.

Cannabinoids in blood and urine after passive inhalation of Cannabis smoke.

Mørland, J · 1985

Five healthy volunteers who had never used cannabis sat in a small closed car (approximately 1,650 liters of air) while other people smoked marijuana or hashish for 30 minutes. Immediately after exposure, THC was detectable in the blood of all five passive smokers at concentrations ranging from 1.3 to 6.3 nanograms per milliliter.

Adverse effects of intravenous cannabis tea.

Mims, R B · 1977

Four youths prepared a tea by boiling cannabis seeds, then injected the liquid directly into their veins.

Intact humoral and cell-mediated immunity in chronic marijuana smoking.

Rachelefsky, G S · 1976

Twelve healthy adults smoked cannabis daily for 64 consecutive days in a controlled hospital setting while researchers tracked multiple immune markers. B-cell counts, initially lower than controls, increased to normal levels over the study period.

Clinical outcomes from a mid-western opioid treatment program during covid-19 emergency regulations: a brief report on the effect of tetrahydrocannabinol (THC) use on take home methadone access.

LaCourt, Erin T · 2026

Among 33 patients in an opioid treatment program with relaxed COVID-era take-home rules, the majority with continuing THC use remained eligible for take-home methadone for 10 months.

Designing an Online and Text-Messaging Intervention to Enhance Protective Behavioral Strategy Utilization at the Daily Level Among Young Adults Engaged in Alcohol and Cannabis Use.

Lewis, Melissa A · 2026

Through focus groups and cognitive interviews with young adults, researchers developed an interactive online intervention followed by 8 weeks of text messages (3 per week) promoting protective behavioral strategies.

Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists.

Hsu, Jennifer · 2025

Across 34 articles and 63 individual cases of CHS, capsaicin cream, antipsychotics, and benzodiazepines were reported to improve symptoms more effectively than standard anti-emetics such as promethazine, ondansetron, and metoclopramide.

Topical Capsaicin for Symptomatic Treatment of Cannabinoid Hyperemesis Syndrome in a Pregnant Patient: A Case Report.

Huang, Jenny · 2025

A 34-year-old woman at 11 weeks gestation with intractable abdominal pain and nausea unresponsive to extensive gastrointestinal workup and multimodal antiemetic treatment was ultimately diagnosed with CHS.

The effects of vaped cannabis on the severity of naloxone-precipitated opioid withdrawal.

Jones, Jermaine D · 2025

In one male participant (age 52) with OUD stabilized on oral morphine (120 mg/day), naloxone alone produced a COWS score of 22 at 30 minutes.

Cannabis or Cannabinoids for the Management of Chronic Noncancer Pain: Best Practice Advice From the American College of Physicians.

Kansagara, Devan · 2025

The ACP developed best practice advice based on systematic reviews, recommending clinicians counsel patients about cannabis for chronic noncancer pain while identifying specific subgroups where harms likely outweigh benefits: young adults and adolescents, patients with substance use disorders, those with serious mental illness, and frail patients at risk for falls..

Droperidol is associated with reduced length of stay in the treatment of cannabinoid hyperemesis syndrome.

Kelly, Geoffrey S · 2025

Among 211 CHS encounters, droperidol use (36.5% of cases) was associated with a 24% reduction in length of stay (mean ratio 0.76, p = 0.01), 66% lower odds of receiving additional medications (OR 0.34, p < 0.001), and 84% lower odds of opioid use (OR 0.16, p < 0.001).

Cannabis retail store density and county-level mortality from injury in the state of Washington from 2009-2020.

Kerr, William C · 2025

Cannabis store density was negatively associated with accidental poisoning deaths (IRR 0.83, 95% CI 0.73-0.93) and opioid mortality (IRR 0.83, 95% CI 0.70-0.99).

Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture.

Kishan, Arman · 2025

Compared to controls, cannabis users (6.7% of cohort) had higher rates of acute kidney injury, cardiac arrest, DVT, hypoglycemia, MI, pneumonia, sepsis, stroke, UTI, surgical site infection, and fracture malunion after metacarpal fracture fixation.

Tetrahydrocannabinol Intoxication from Food at a Restaurant - Wisconsin, October 2024.

Kita-Yarbro, Amanda · 2025

After a restaurant ran out of cooking oil and used oil from a shared kitchen that contained hemp-derived delta-9-THC, 85 people met the case definition for THC intoxication.

Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain.

Kitchen, Chenai · 2025

Daily cannabis use was associated with a 40% higher rate of opioid cessation (adjusted HR 1.40, 95% CI 1.08-1.81, p = 0.011).

Breaking the cycle: Consequences from simultaneous alcohol and cannabis use predict subsequent simultaneous use and drinks consumed at the next simultaneous use event.

Tolbert, Riley C · 2025

Negative consequences from simultaneous alcohol-cannabis use predicted higher likelihood of cannabis use at the next drinking event (contrary to hypotheses) but fewer drinks at the next simultaneous use event.

Severe and rapidly changing hypophosphatemia in cannabinoid hyperemesis syndrome: a case report.

Acharya, Prakash · 2024

An 18-year-old male with daily cannabis use presented with CHS and developed severe hypophosphatemia (low blood phosphorus) that changed rapidly, requiring careful monitoring and correction.

Marijuana's Impact On Implant-based Breast Reconstruction: A Retrospective Cohort Study.

Al-Saghir, Tala · 2024

Among 243 patients undergoing immediate direct-to-implant breast reconstruction, 12 active cannabis users showed significantly higher rates of cellulitis requiring IV antibiotics, explantation for infection, ER visits, readmission, and reoperation within 90 days compared to non-users..

"Everything is kind of the same except my mind is with me": exploring cannabis substitution in a sample of adults in early recovery from an opioid or stimulant addiction.

Beaugard, Corinne A · 2024

Participants found cannabis appealing for its safer profile (no overdose risk, safe supply, few side effects).

Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department.

Borgundvaag, Bjug · 2024

The GRACE-4 panel issued two CHS-specific recommendations: use of haloperidol or droperidol alongside standard antiemetics, and offering topical capsaicin as an additional option, both graded at very low certainty of evidence..

Contingency management is associated with positive changes in attitudes and reductions in cannabis use even after discontinuation of incentives among non-treatment seeking youth.

Cooke, Megan E · 2024

Abstinence-incentivized participants showed significant reductions in cannabis use frequency and biochemically verified THC metabolites at 4-week follow-up compared to monitoring-only controls.

The impact of cannabis on non-medical opioid use among individuals receiving pharmacotherapies for opioid use disorder: a systematic review and meta-analysis of longitudinal studies.

Costa, Gabriel P A · 2024

The pooled odds ratio was 1.00 (95% CI: 0.97-1.04, p=.98), indicating no association between cannabis use and non-medical opioid use during OUD treatment.

Prevalence and trends of suspected cannabinoid hyperemesis syndrome over an 11-year period in Northern California: An electronic health record study.

Costales, Brianna · 2024

Using a narrow CHS definition, annual prevalence increased by 175% from 2009 to 2019 (prevalence ratio=2.75).

Dual-Vaping of Nicotine and Cannabis Among Adults Who Currently Use Tobacco Products in Five New England States.

Liu, Jessica · 2024

26.1% of past-month tobacco users who vaped reported dual-vaping both nicotine and cannabis/CBD in the past 30 days.

A content analysis of cannabis edibles package marketing in the United States.

Reboussin, Beth A · 2024

Health-related descriptors appeared on 31% of packages (e.g., "vegan," "gluten free," "natural"), quality descriptors on 28% ("handcrafted"), expected effects on 27% ("relax"), taste/flavor language on 21%, and pharmacokinetic claims on 19% ("fast-acting").

Cannabis use to manage stimulant cravings among people who use unregulated drugs.

Reddon, Hudson · 2024

Cannabis use to manage stimulant cravings was reported by 134 of 297 participants (45.1%).

Cannabis use disorders and outcome of admission to intensive care: A retrospective multi-centre cohort study.

Renger, Laura · 2024

Of 34,680 ICU admissions, 292 (0.8%) had cannabis-related diagnoses.

Trends in Substance Use-related Emergency Department Visits by Youth, 2018-2023.

Renny, Madeline H · 2024

Substance use-related ED visits increased from 2.8% to 3.4% (p < 0.001).

AGA Clinical Practice Update on Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Commentary.

Rubio-Tapia, Alberto · 2024

The AGA Clinical Practice Update provides consensus expert guidance on recognizing, diagnosing, and treating CHS, a condition characterized by cyclic nausea, vomiting, and compulsive hot water bathing in the setting of chronic cannabis use.

Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure.

Russo, Ethan B · 2024

Five genetic mutations distinguish CHS patients from asymptomatic heavy cannabis users: mutations in TRPV1 receptor, two dopamine genes, the CYP2C9 enzyme (which metabolizes THC), and the ATP-binding cassette transporter.

SAEM GRACE: Dopamine antagonists and topical capsaicin for cannabis hyperemesis syndrome in the emergency department: A systematic review of direct evidence.

Sabbineni, Monica · 2024

Of 7 included studies (5 observational, 2 RCTs; 492 total patients), 5 evaluated capsaicin cream (n=386) with mixed results, and 2 evaluated dopamine antagonists (n=106) with both detecting clinical benefit compared to usual care.

Fatal Overdose with the Cannabinoid Receptor Agonists MDMB-4en-PINACA and 4F-ABUTINACA: A Case Report and Review of the Literature.

Simon, Gábor · 2023

Forensic analysis confirmed the presence of both MDMB-4en-PINACA and 4F-ABUTINACA in the deceased, with autopsy revealing acute myocardial ischemia and pulmonary edema consistent with synthetic cannabinoid toxicity..

Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies.

Solmi, Marco · 2023

Of hundreds of reported associations, only a handful met the threshold for convincing or highly suggestive evidence.

Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome.

Wightman, Rachel S · 2023

Whole-blood cannabinoid profiles differed between symptomatic and asymptomatic periods in patients with suspected CHS, providing biological data to complement clinical diagnosis.

An analysis of cannabinoid hyperemesis syndrome Reddit posts and themes.

Wightman, Rachel S · 2023

CHS Reddit community members discussed triggers, therapies, and personal experiences with the condition.

Cannabinoid hyperemesis syndrome presenting with ventricular bigeminy.

Wong, Jeffrey · 2023

CHS presentation included ventricular bigeminy (alternating normal and premature ventricular heartbeats) detected on the pre-arrival EMS EKG.