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Published: 13 May 2024

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Psychosis is an increasing risk of today's strong marijuana.

KEY POINTS

• Young adults and teens can develop an addiction to weed and become psychotic.
• Many people don’t know that regular marijuana use may carry serious health risks, especially for the young.
• No medication is FDA-approved for treating cannabis use disorder.
• One cannabis-induced psychotic episode ups the risk of developing bipolar disorder or schizophrenia by 50%.
• Cannabis use disorder (CUD) is also increasing; in 2022, 5.7 million people met diagnostic criteria for this disorder.

(Source: Psychology Today April 2024)

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Published: 09 May 2024

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Marijuana-induced Coronary Vasospasm with Persistent Inter-coronary Connection: A Case Report and Review of Literature

Coronary vasospasm is a well-known entity causing acute chest syndrome and can lead to myocardial infarction, ventricular arrhythmias, and even sudden cardiac death. While there are extensive case series showing the association of coronary vasospasm with cocaine, studies reporting marijuana-induced coronary vasospasm are limited in number. We herein present a case of coronary vasospasm in a middle-aged African-American male who presented to the emergency department after an episode of syncope. His urine drug screen was positive only for marijuana. He had a transient elevation of ST segments on his EKG with concomitant wall motion abnormalities on echocardiogram and was later found to have vasospasm of coronary arteries on coronary angiogram without any evidence of focal atherosclerotic disease. Another interesting finding was the persistent inter-coronary communication or coronary arcade connecting the left circumflex artery to the right coronary artery. There was bi-directional flow through the inter-coronary communication and hence, we believe this communication prevented our patient from experiencing acute chest symptoms or myocardial infarction. It is important for the clinicians to recognize the association of marijuana with coronary vasospasm. At the same time, these patients should be treated as acute coronary syndromes until proven otherwise by ischemia evaluation.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726350/

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Published: 07 May 2024

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Chronic Pain Associated With Increased Cannabis Use and Adverse Effects Among Young Adults

Nonmedical cannabis use is on this rise in adults suffering from pain, despite evidence demonstrating negative clinical outcomes. Researchers investigated the relationship between cannabis use, adverse consequences, and chronic pain in a US-based cohort of young adults aged 18–25 years.

• The sample of 403 young adults reported a mean cannabis use of 47 days in the prior 90 days; of this sample, 20 percent reported chronic pain.
• Participants with chronic pain used cannabis at significantly greater frequency (incident rate ratio [IRR], 1.35), intensity (IRR, 1.61), and reported more negative consequences (IRR, 1.23), compared with those without chronic pain.

Comments: This study contributes to a growing body of evidence that young people with chronic pain have increased cannabis use compared with their peers and experience more adverse effects. Youth are neuro-developmentally vulnerable to cannabis’s effects, with brain maturation occurring through the mid-twenties. Cultural messages that promote cannabis as a “medication” appear to be drowning out accurate information about the risks of use for this age group. Given the implications, young adults should be advised of non-cannabis alternatives to mitigate chronic pain.

(Source: Boston Medical Centre, Emily Nields, DO)

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Published: 07 May 2024

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Introduction: The increase of cannabis use, particularly with the evolution of high potency products, and of cannabis use disorder (CUD) are a growing health care concern. While the harms of adult use and potential medicinal properties of cannabis continue to be debated, it is becoming evident that adolescent cannabis use is a critical window for CUD risk with potential lifelong mental health implications. Herein, we discuss mental health consequences of adolescent cannabis use, factors that contribute to the risk of developing CUD, and w(S(hat remains unclear in the changing legal landscape of cannabis use. We also discuss the importance of preclinical models to provide translational insight about the causal relationship of cannabis to CUD-related phenotypes and conclude by highlighting opportunities for clinicians and allied professionals to engage in addressing adolescent cannabis use.

Conclusion: The relationship between developmental cannabis, the impact of high potency products, and increased risk of developing CUD and mental health problems must be taken seriously, especially in light of the current mental health crisis. The plasticity of the developing brain offers windows of opportunity for prevention and early intervention to change that trajectory. Clearly new treatment strategies are needed to address the mounting challenge of CUD risk in teens and young adults. While data accumulated over the past decades about the effects of now “low dose” THC has been very valuable, significant research efforts in preclinical models are needed, focused on THC potency relevant to today’s products. Additionally, longitudinal studies such as ABCD should be able to provide important insights about factors related to resilience that may also help guide the development of intervention strategies. Altogether, the combined longitudinal, clinical and preclinical efforts will help provide unprecedented knowledge to mitigate the trajectory of CUD and related psychiatric disorders, both of which have a strong neurodevelopmental etiology.

(Source: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20231006