cannabis

Cannabis sativa is being medicinally used by humans and is well known for its recreational uses. Seizure is exceedingly rarely seen following cannabis use. Various cellular mechanisms have been suggested in the occurrence of seizures caused by cannabinoids.

Case: 

The patient was a 28-year-old man who complained of weakness, lethargy, and convulsions after consuming cannabis (hashish). The laboratory findings and brain CT were normal. The patient's toxicity panel was positive for hashish.

Physicians working in the emergency department should be aware that hashish may cause seizures. Although several investigations have shown anticonvulsant effects for cannabis.

The beneficial effect of transcranial direct current stimulation (tDCS) on substance use disorders, achieved by reducing craving, impulsivity, and risk-taking behavior, can be considered an effective therapeutic approach.Transcranial direct current stimulation can be considered an effective therapeutic approach for reducing cannabis craving, improving levels of depression, and enhancing working memory in cannabis users.

This study investigated the effectiveness of tDCS applied to the Dorsolateral prefrontal cortex (DLPFC) on craving, depression, and working memory in cannabis users.

This was a randomized, sham-controlled, double-blind, parallel-group study. Fifty male participants who met the criteria for cannabis use disorder according to DSM-5 were randomly assigned to either the real tDCS group (25 participants) or the sham tDCS group (25 participants). Pretests, including marijuana urine tests, the Marijuana Craving Questionnaire-Short Form (MCQ-SF), the Hamilton Depression Rating Scale (HDRS), and the Wechsler Memory Scale, were conducted before the intervention. The real tDCS group underwent 20 sessions of tDCS stimulation, each lasting 20 minutes, with a current intensity of 2 milliamperes applied at the F3 and F4 positions for DLPFC stimulation. The sham tDCS group received only 30 seconds of initial electrical stimulation, with no further current delivered. Both groups also received standard psychological treatments alongside the tDCS interventions. After completing the interventions, the same tests were administered again to assess the outcomes.

Participants who received real tDCS showed significant improvement in levels of craving, depression, and working memory. This reduction in scores and levels was statistically significant compared to the sham group.

Transcranial direct current stimulation can be considered an effective therapeutic approach for reducing cannabis craving, improving levels of depression, and enhancing working memory in cannabis users.

Growing evidence indicates that adolescent substance abuse is now an alarming concern that imposes a considerable socio-economic burden on societies. On the other hand, numerous studies have shown that due to specific neurophysiological features, the brain is more vulnerable to the adverse effects of psychoactive drugs at an early age. Unfortunately, these negative effects are not limited to the period of drug use, but can persistently affect the brain’s responsiveness to future exposures to the same or other types of drug. For researchers to develop pharmacological strategies for managing substance abuse disorders, they need to gain a deep understanding of the differences in behavioral outcomes associated with each type of drug across different age groups. The present study was conducted to review the experimental evidence revealing the mentioned differential effects with an emphasis on common drugs of abuse, including cocaine, nicotine, cannabis, and opioids. Although the cellular mechanisms underlying age-related effects have not been exclusively addressed for each drug, the most recent results are presented and discussed. Future studies are required to focus on these mechanisms and reveal how molecular changes during brain development can result in differential responses to drugs at the behavioral level.

Cannabis, commonly known as marijuana, is widely used for recreational purposes. It has stimulatory effect on appetite, so cannabinoid receptor antagonists have been used to decrease food intake and to act peripherally by rising thermogenesis and energy expenditure to control obesity. This in vitro study determined morphological, growth, apoptosis and differential potential of changes in dental pulp stem cells (DPSCs) when marijuana wasadded to nutrients of cell culture medium. Wisdom teeth extracted were used to obtain DPSCs, while characterized morphologically, by osteo- and adipo-inductions and flowcytometry for mesenchymal properties. MTT assay identified optimal concentration of cannabis extract. Cells were treated with 120 and 1000 ng/mL of cannabis during seven days period, while proliferation, apoptosis and differentiation of DPSCs were assessed. DPSCs were spindle shape and showed mesenchymal characteristics. MTT assay illustrated an increase in cell number until day 5th when DPSCs were treated with 120 and 1000 ng/mL of cannabis, while there was a decreasing trend on day 6th. There was an upregulation of the expression of Bax and COL1A1genes on day 6th when 120 and 1000 ng/mL of cannabis were added to the media in comparison to the control group. The increase in DPSC proliferation and viability when treated with cannabis denotes to its positive impact on cell proliferation during short term period, while a long term exposure to cannabis resulted in apoptosis and a decrease in cell proliferation. These findings reveal an issue of public health concern and alarm for health authorities.

 Maajoune is a dough prepared using hemp resin and certain plants known for their aphrodisiac effects. This drug is manufactured in North African countries.

 The goal of this study was to seek the neurocognitive effects of the Maâjoune among children and young individuals.

 This randomized case-control study was conducted in three addiction centers and four schools in Morocco’s central region. The neurocognitive evaluation was performed by the Bells Test (visual attention deficits, unilateral spatial neglect, memory, and executive functions). SPSS software (version 20) was used to perform statistical analysis consisting of descriptive and qualitative analyses.

 This study was conducted on 115 participants aged between 10 and 18 years. The subjects were divided into two groups, namely 55 subjects (48%) (G1) addicted to Maajoune and 60 subjects (52%) (G2) as non-consumers (control group). The results showed the omission of 6 items for 73% and 42% in G1 and G2, respectively (P < 0.05). Hemianopsia was detected as bilateral visuospatial neglect (BVN) for 36% (G1) and 17% (G2) (P < 0.05) and right visuospatial neglect for 24% (G1) and 13% (G2) (P < 0.05). The addicted group score was significant regarding attention disorder (P = 0.001‡) and memory troubles (P < 0.000001‡).

 The study results confirmed that Maajoune consumption significantly affected attention, executive function, and memory in young individuals. These findings highlight the urgent need for research that elucidates the neurobiological changes caused by Maajoune consumption in human health.

The perception of Cannabis toxicity and safety in society, politics, and even scientific circles has changed dramatically in recent years. Consequently, a few questions have been raised regarding the effects of marijuana (Cannabis sativa) on the human body and psychic abilities in the short and long term. This study is undertaken in order to compare sperm cells quality before and after incubation with Cannabis (marijuana) extracts (THC- THC-COOH and CBD).

Semen samples were obtained from men (n=10) with age range between 20 to 35, regardless of their fertility status. Analyses of semen parameters (volume, sperm count, motility), were analyzed within 1 hour after collection, according to WHO criteria 2020. For accurate results, Computer Assisted Sperm Analysis (CASA) system was used to determine sperm parameters. Each sample was exposed to 1 mL; 10 µg/mL of THC, THC-COOH, and CBD dissolved in methanol. All samples were also exposed to 1 mL pure methanol as a control group to eliminate the potential effects of methanol on sperm cells. Several smears (10 µL) of each sample were taken in order to assess the functionality of sperm’s chromatin integrity by employing a chromomycin (CMA3 ) and DNA fragmentation (Acridine Orange) assays.

After treatment sperm cells with 10µL THC, THC-COOH and CBD. Total sperm’s motility was significantly reduced significantly when it was exposed to THC and CBD (P ≤ 0.001 and P ≤ 0.003 respectively). Progressive motility were decreased significantly (P ≤0.001) and the mean number of immotile sperm were significantly increased (P ≤ 0.003) after incubation with THC and CBD and respectively. However, slightly inhibition of total sperm’s motility was observed after incubation with THC-COOH.

Spermatozoa exposure to THC, CBD and THC-COOH deteriorate significantly sperm motility and should be avoided by men in reproductive age and those who undergoing ART.

Since cannabis has been legally allowed for medicinal purposes in many countries, it has become the most interesting issue, particularly in neurologic disorders, such as Alzheimer’s disease (AD). Inhibition of acetylcholinesterase (AChE) is one of the mechanisms for the treatment of AD.

The present study aimed to establish a method for the preparation of cannabinoid-rich extracts and determine their AChE inhibitory activity.

The cannabinoid-rich extracts were prepared through a green extraction process using microwave-assisted extraction (MAE) followed by hydrophobic column separation. The contents of cannabidiol (CBD) and Δ-9-tetrahydrocannabinol (THC) were determined using high-performance liquid chromatography (HPLC). In vitro AChE inhibitory activity was determined via the photometric method using AChE from Electrophorus electricus.

Three cannabinoids-rich fractions were obtained with different concentrations of CBD and THC, namely Fractions I (CBD of 8.1% w/w; THC of 52.2% w/w), II (CBD of 9.2% w/w; THC of 8.0% w/w), and III (CBD 1.3% w/w, THC 33.5% w/w). These cannabinoid-rich extracts exhibited AChE inhibitory activity, with IC50 values of 52.3, 59.8, and 71.2 µg/mL, respectively.

This finding suggests that CBD, but not THC, might be an active compound contributing to AChE inhibitory effect.

The effect of different types of substances on brain function is still challenging; however, many studies have shown the functional and structural damage to the brain under influence of substance abuse. 

This study aimed to quantitatively compare the effect of opioid (Op), methamphetamine (Meth), cannabis (Can), and simultaneous methamphetamine and opioid (Multi-Drug (MD)) abuse on brain function. Furthermore, the impacts of pure Op and Meth abuse were considered with simultaneous substance abuse.

In this descriptive study, the electroencephalogram (EEG) signal was recorded from 52 participants in the Meth, Op, Can, and MD abusers, and the Healthy Control (HC) groups at rest state. EEG data were analyzed on the frequency domain with electrode-based, cortex-based, and hemisphere-based approaches. 

However, the power spectrum in the delta band in the Op group, the gamma band in the Can group, and the gamma and beta bands in the MD group more significantly increased compared to the HC group, the power spectrum values in the Meth group reduced in the alpha, beta, and gamma bands. Moreover, the power spectrum values in the MD group more significantly higher than the Meth and Op groups in the beta and gamma bands.

Since substance abuse in different types caused various changes in frequency components, the different power spectrum bands analysis in abusers can be reasonable to apply as a biomarker to detect the drug types.

Synthetic cannabinoids (SC) are a heterogeneous group of substances with a high affinity for cannabinoid receptors. Unlike Δ9-tetrahydrocannabinol (THC), synthetic cannabinoids are incredibly potent, highly productive, have more affinity for the Cannabinoid receptor type 1 (CB1), and Cannabinoid receptor type 2 (CB2), and are designed to accelerate the effects of tetrahydrocannabinol. Also, there is experimental evidence that SCs acts on non-cannabinoid receptors, such as the 5-HT2B receptor or dopaminergic receptors. (1, 2).

Substance abuse is a public health concern given its high prevalence worldwide. The early onset of such abuse predicts greater severity of addiction, morbidity, and use of multiple drugs. The use of psychoactive substances among Brazilian university students is frequent and cannabis stands out as the most consumed illicit drug. This study aimed to assess the prevalence of cannabis use among medical students from public universities in the state of São Paulo, correlating it with socioeconomic data, perceptions, and conceptions about use, triggering factors and possible implications in academic performance.

The data were collected using an anonymous online survey, which was sent to students attending public medical universities in the state of São Paulo in the year 2020.

The survey was answered by 225 participants. Among all participants, 147 (65.3%) reported at least one episode of cannabis use during their study in university. 91 (61.9%) reported the first use before entering university, while 56 (38.1%) used it for the first time during the university years. The frequent group included 41 (27.9%) people and the sporadic group included 106 (72.1%) people.

The present study indicated that the medical students in public universities in the state of São Paulo have higher cannabis use rates compared to the general Brazilian population and to other medical students worldwide. The users are aware of the possible damages caused by cannabis use, but this does not stop them from smoking.

Drug abuses have become an important part of the emergency service admissions. As a result of MDMA (3,4-methylenedioxy-methamphetamine) intake, various side effects may occur; from minor to major conditions. After using cannabis alone is cardiovascular symptoms, respiratory symptoms, nausea/vomiting and neurological symptoms. We presented the MDMA and cannabis intake case which resulted in multiple major adverse events and death in the emergency department.

 A nineteen-year-old male patient was brought to the emergency department with generalized tonic-clonic seizure. On admission, the patient had hypoglycemia and his urine was positive for cannabis and amphetamine. Liver, renal failure, DIC and methemoglobinemia developed. Although he received noradrenaline and dopamine infusion due to hypotension, his hypotension deepened. During the follow-up, cardiac arrest developed and after 30 minutes of cardiopulmonary resuscitation, death was accepted.

It is a phenomenon in which severe side effects occur after intake of MDMA and cannabis and result in death. MDMA is inhibited by the CYP2D6 enzyme and is excreted renally. The presence of drugs that inhibit this enzyme, the development of kidney failure, and the genetic polymorphism of the enzyme may cause these effects.

The use of street drugs can cause death with many serious side effects.

Cannabis use is considered a major clinical problem associated with a poorer outcome in patients with schizophrenia. The objective of the present study was to assess the prevalence of cannabis us among patients with schizophrenia. The assessment consists in comparing some factors related to substance use in a population of schizophrenic patients between cannabis users and non-users. Four hundred and three participants who were examined prospectively during their hospitalization answered the PANNS scale of schizophrenia, GAF, BIS-10, CDSS, and MARS. The consumption of cannabis was investigated using urine toxicological analysis. Sociodemographic, clinical and therapeutic data were also recorded. The prevalence of cannabis use among schizophrenic inpatients was 49%. Patients with cannabis use were younger (31.7 vs 34.9 years old, p<0.001), more often male (52 vs 20% female, p<0.001), and they presented more often a history of imprisonment (68.8% vs 31.2%, p<0.001). Patients who were users of cannabis had a lower age at onset of the disease than non-users (23.6 vs 24.8 years, p=0.029), and more often with poor medication adherence (p=0.001). Logistic regression revealed that factors associated with cannabis use among schizophrenics were the age, gender, history of imprisonment and poor medication adherence. The study showed that a high prevalence of cannabis use among patients with schizophrenia which was associated with negative overall outcomes. Determining comorbid substance use disorders among schizophrenic patients is crucial as it may contribute to establish a better therapeutic strategy.