Transcultural aspects of cannabis use : a descriptive overview of cannabis use across cultures

Purpose of Review: This narrative review summarises cultural aspects of cannabis use across different (sub)cultures, nations, and gender, racial, and ethnic groups. Specifically, we aimed to overview historical and traditional contexts of cannabis use and physical and mental health-related correlates, as well as emerging cannabis-related policies and their impacts on medicinal and recreational use of cannabis. In addition, we discuss how cultural factors may affect cannabis use behaviours and sociocultural underpinnings of cannabis use disorder trajectories. Recent Findings: Cannabis is the most widely cultivated, trafficked, and used illicit drug worldwide, although cannabis is being legalised in many jurisdictions. More than 4% of individuals globally have used cannabis in the last year. Being traditionally used for religious and ritualistic purposes, today cannabis use is interwoven with, and influenced by, social, legal, economic, and cultural environments which often differ across countries and cultures. Notably, empirical data on distinct aspects of cannabis use are lacking in selected underrepresented countries, geographical regions, and minority groups. Summary: Emerging global policies and legislative frameworks related to cannabis use have impacted the prevalence and attitudes toward cannabis in different subcultures, but not all in the same way. Therefore, it remains to be elucidated how and why distinct cultures differ in terms of cannabis use. In order to understand complex and bidirectional relationships between cannabis use and cultures, we recommend the use of cross-cultural frameworks for the study of cannabis use and its consequences and to inform vulnerable people, clinical practitioners, and legislators from different world regions.Publisher PDFPeer reviewe

Adverse effects of cannabidiol:a systematic review and meta-analysis of randomized clinical trials

Cannabidiol (CBD) is being investigated as a treatment for several medical disorders but there is uncertainty about its safety. We conducted the first systematic review and meta-analysis of the adverse effects of CBD across all medical indications. Double-blind randomized placebo-controlled clinical trials lasting ≥7 days were included. Twelve trials contributed data from 803 participants to the meta-analysis. Compared with placebo, CBD was associated with an increased likelihood of withdrawal for any reason (OR 2.61, 95% CI: 1.38-4.96) or due to adverse events (OR 2.65, 95% CI: 1.04-6.80), any serious adverse event (OR 2.30, 95% CI: 1.18-4.48), serious adverse events related to abnormal liver function tests (OR 11.19, 95% CI: 2.09-60.02) or pneumonia (OR 5.37, 95% CI: 1.17-24.65), any adverse event (OR 1.55, 95% CI: 1.03-2.33), adverse events due to decreased appetite (OR 3.56, 95% CI: 1.94-6.53), diarrhoea (OR 2.61, 95% CI: 1.46-4.67), somnolence (OR 2.23, 95% CI: 1.07-4.64) and sedation (OR 4.21, 95% CI: 1.18-15.01). Associations with abnormal liver function tests, somnolence, sedation and pneumonia were limited to childhood epilepsy studies, where CBD may have interacted with other medications such as clobazam and/or sodium valproate. After excluding studies in childhood epilepsy, the only adverse outcome associated with CBD treatment was diarrhoea (OR 5.03, 95% CI: 1.44-17.61). In summary, the available data from clinical trials suggest that CBD is well tolerated and has relatively few serious adverse effects, however interactions with other medications should be monitored carefully. Additional safety data from clinical trials outside of childhood epilepsy syndromes and from studies of over-the-counter CBD products are needed to assess whether the conclusions drawn from clinical trials can be applied more broadly.</p

Can we make cannabis safer?

Cannabis use and related problems are on the rise globally alongside an increase in the potency of cannabis sold on both black and legal markets. Additionally, there has been a shift towards abandoning prohibition for a less punitive and more permissive legal stance on cannabis, such as decriminalisation and legalisation. It is therefore crucial that we explore new and innovative ways to reduce harm. Research has found cannabis with high concentrations of its main active ingredient, δ-9-tetrahydrocannabinol (THC), to be more harmful (in terms of causing the main risks associated with cannabis use, such as addiction, psychosis, and cognitive impairment) than cannabis with lower concentrations of THC. By contrast, cannabidiol, which is a non-intoxicating and potentially therapeutic component of cannabis, has been found to reduce the negative effects of cannabis use. Here, we briefly review findings from studies investigating various types of cannabis and discuss how future research can help to better understand and reduce the risks of cannabis use

Changes in the composition of cannabis from 2000-2017 in Denmark:Analysis of confiscated samples of cannabis resin

Globally, recent studies report increases in Δ-9-tetrahydrocannabinol (THC) concentration in seized samples of cannabis for human consumption. This is important, because use of cannabis with a high concentration of THC has been linked to a number of adverse health outcomes. The objective of this study was to assess recent changes in the composition of seized cannabis resin in Denmark by (a) examining THC concentration in samples from Danish forensic laboratories from 2000 to 2017 ( N = 430) and (b) examining cannabidiol (CBD) concentration and the THC:CBD concentration ratio in samples from the forensic laboratory in Western Denmark from 2008 to 2017 ( N = 147). Cannabis resin samples were analyzed using a gas chromatographic analysis with flame ionization detection quantifying the total THC and CBD concentration. Results showed that the THC concentration increased 3-fold from 2000 (mean: 8.3%) to 2017 (mean: 25.3%). Significant increases occurred in all areas of Denmark. After 2011, we found a dramatic increase in cannabis resin samples with high THC concentration and the near disappearance of cannabis resin samples with medium- and low THC concentration. Furthermore, the THC:CBD concentration ratio increased significantly from 1.4 in 2008 to 4.4 in 2017. Whereas THC concentration increased, CBD concentration remained stable at ∼6%. In conclusion, the THC concentration of cannabis resin, and THC:CBD concentration ratio, have increased dramatically in Denmark, potentially leading to higher risk of harm to users. Policymakers, treatment professionals, and educators should be aware of this change. (PsycINFO Database Record (c) 2019 APA, all rights reserved). </p

The International Cannabis Toolkit (iCannToolkit) : A multidisciplinary expert consensus on minimum standards for measuring cannabis use

Background The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. Methods A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. Results The expert-based consensus agreed upon a three-layered hierarchical framework. Each layer—universal measures, detailed self-report and biological measures—reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. Conclusions Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation

Enhanced Single Photon Emission from a Diamond-Silver Aperture

We have developed a scalable method for coupling single color centers in diamond to plasmonic resonators and demonstrated Purcell enhancement of the single photon emission rate of nitrogen-vacancy (NV) centers. Our structures consist of single nitrogen-vacancy (NV) center-containing diamond nanoposts embedded in a thin silver film. We have utilized the strong plasmon resonances in the diamond-silver apertures to enhance the spontaneous emission of the enclosed dipole. The devices were realized by a combination of ion implantation and top-down nanofabrication techniques, which have enabled deterministic coupling between single NV centers and the plasmonic modes for multiple devices in parallel. The plasmon-enhanced NV centers exhibited over six-fold improvements in spontaneous emission rate in comparison to bare nanoposts and up to a factor of 3.6 in radiative lifetime reduction over bulk samples, with comparable increases in photon counts. The hybrid diamond-plasmon system presented here could provide a stable platform for the implementation of diamond-based quantum information processing and magnetometry schemes.Comment: 16 pages, 4 figure